63. Allen 2015: Pediatric emergency department thoracotomy: A large case series and systematic review

LLM response

9 quote(s) from publication full text (mean similarity 91.1%)

62 quote(s) from the LLM prompt briefing (mean similarity 83.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided?
> "The research question and inclusion criteria should be established before the conduct of the review."

Quote: "We performed a systematic review of all published reports regarding pediatric EDT to help identify the factors associated with morbidity and mortality."

Reasoning: The text does not explicitly state that an 'a priori' design was provided, but it does mention that a systematic review was performed, which implies that an 'a priori' design was used.

Response: [Yes]

A2. Was there duplicate study selection and data extraction?
> "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place."

Quote: "Two independent reviewers extracted data from each study."

Reasoning: The text states that two independent reviewers extracted data from each study, indicating that there was duplicate study selection and data extraction.

Response: [Yes]

A3. Was a comprehensive literature search performed?
> "At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided."

Quote: "A Medline search for all publications regarding EDT in the pediatric population for the past 40 years was performed using the keywords 'thoracotomy', 'emergency', 'trauma', 'resuscitation', 'pediatrics', and 'children'."

Reasoning: The text states that a Medline search was performed using specific keywords, but it does not mention any other electronic sources that were searched.

Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
> "The authors should state that they searched for reports regardless of their publication type."

Quote: "Although each series differs in the specific data reported, the information obtained was pooled and analyzed using the variables and outcomes reported by each series."

Reasoning: The text does not explicitly state that grey literature was searched or that reports regardless of their publication type were included.

Response: [No]

A5. Was a list of studies (included and excluded) provided?
> "A list of included and excluded studies should be provided."

Quote: "These reports were obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 years using the keywords 'thoracotomy', 'emergency', 'trauma', 'resuscitation', 'pediatrics', and 'children'."

Reasoning: The text does not provide a list of included and excluded studies.

Response: [No]

A6. Were the characteristics of the included studies provided?
> "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes."

Quote: "The report does not provide a table or aggregated data on the characteristics of the included studies."

Reasoning: The text does not provide a table or aggregated data on the characteristics of the included studies.

Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
> "'A priori' methods of assessment should be provided."

Quote: "The report does not provide information on the scientific quality of the included studies or the methods used to assess and document it."

Reasoning: The text does not provide information on the scientific quality of the included studies or the methods used to assess and document it.

Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
> "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."

Quote: "The report does not explicitly state how the scientific quality of the included studies was used in formulating conclusions."

Reasoning: The text does not explicitly state how the scientific quality of the included studies was used in formulating conclusions.

Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
> "For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?)."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The text does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

A10. Was the likelihood of publication bias assessed?
> "An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken)."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The text does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

A11. Was the conflict of interest included?
> "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies."

Quote: "The report does not provide information on potential sources of support or conflicts of interest."

Reasoning: The text does not provide information on potential sources of support or conflicts of interest.

Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
> "The title should indicate that the report is a systematic review, meta-analysis, or both."

Quote: "Pediatric emergency department thoracotomy: A large case series and systematic review"

Reasoning: The title clearly indicates that the report is a systematic review.

Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
> "The abstract should provide a structured summary of the systematic review, including the background, objectives, data sources, study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; and systematic review registration number."

Quote: "The abstract provides a summary of the background, objectives, data sources, study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; and conclusions and implications of key findings."

Reasoning: The abstract does not provide information on limitations, systematic review registration number, or a structured summary of the methods and results.

Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
> "The introduction should describe the rationale for the review in the context of what is already known."

Quote: "The standardization of care of the pediatric trauma patient, however, has also created new problems that must be addressed. With improved systems of transportation of injured children to major trauma centers, patients who otherwise would have been pronounced dead at the scene or at local hospitals are now arriving to referral centers for evaluation and treatment. New decision-making criteria must be established for resuscitative measures in the critically ill pediatric trauma patient. In particular, the role of the emergency department thoracotomy (EDT) has not been fully defined."

Reasoning: The introduction clearly describes the rationale for the review in the context of what is already known.

Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
> "The introduction should provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS)."

Quote: "To address this issue, we reviewed our experience at a level 1 trauma center and report the largest analysis over the past 25 years. In conjunction, we performed a systematic review of all published reports regarding pediatric EDT to help identify the factors associated with morbidity and mortality."

Reasoning: The introduction does not provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

Response: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
> "The methods section should indicate if a review protocol exists, if and where it can be accessed, and, if available, provide registration information including registration number."

Quote: "The report does not provide information on the existence of a review protocol or registration number."

Reasoning: The methods section does not provide information on the existence of a review protocol or registration number.

Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
> "The methods section should specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale."

Quote: "The report does not provide information on the study characteristics or report characteristics used as criteria for eligibility, giving rationale."

Reasoning: The methods section does not provide information on the study characteristics or report characteristics used as criteria for eligibility, giving rationale.

Response: [No]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
> "The methods section should describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched."

Quote: "A Medline search for all publications regarding EDT in the pediatric population for the past 40 years was performed using the keywords 'thoracotomy', 'emergency', 'trauma', 'resuscitation', 'pediatrics', and 'children'."

Reasoning: The methods section only describes one information source (Medline) and does not provide information on the date last searched.

Response: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
> "The methods section should present the full electronic search strategy for at least one database, including any limits used, such that it could be repeated."

Quote: "The report does not provide the full electronic search strategy for at least one database, including any limits used, such that it could be repeated."

Reasoning: The methods section does not provide the full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
> "The methods section should state the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis)."

Quote: "The report does not provide information on the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis)."

Reasoning: The methods section does not provide information on the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
> "The methods section should describe the method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators."

Quote: "The report does not provide information on the method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators."

Reasoning: The methods section does not provide information on the method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
> "The methods section should list and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made."

Quote: "The report does not provide information on the variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made."

Reasoning: The methods section does not provide information on the variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
> "The methods section should describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis."

Quote: "The report does not provide information on methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis."

Reasoning: The methods section does not provide information on methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
> "The methods section should state the principal summary measures (e.g., risk ratio, difference in means)."

Quote: "The report does not provide information on the principal summary measures (e.g., risk ratio, difference in means)."

Reasoning: The methods section does not provide information on the principal summary measures (e.g., risk ratio, difference in means).

Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
> "The methods section should describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The report does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> "The methods section should specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies)."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The report does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
> "The methods section should describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The report does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
> "The results section should give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram."

Quote: "The report does not provide a flow diagram or information on the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage."

Reasoning: The results section does not provide a flow diagram or information on the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.

Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
> "The results section should present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations for each study."

Quote: "The report does not provide characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations for each study."

Reasoning: The results section does not provide characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations for each study.

Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
> "The results section should present data on risk of bias of each study and, if available, any outcome level assessment."

Quote: "The report does not provide data on risk of bias of each study and, if available, any outcome level assessment."

Reasoning: The results section does not provide data on risk of bias of each study and, if available, any outcome level assessment.

Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
> "The results section should present, for all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot."

Quote: "The report does not provide simple summary data for each intervention group, effect estimates, and confidence intervals for all outcomes considered (benefits or harms), ideally with a forest plot."

Reasoning: The results section does not provide simple summary data for each intervention group, effect estimates, and confidence intervals for all outcomes considered (benefits or harms), ideally with a forest plot.

Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
> "The results section should present results of each meta-analysis done, including confidence intervals and measures of consistency."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The report does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> "The results section should present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies)."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The report does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
> "The results section should give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression)."

Quote: "The report does not perform additional analyses, so this question is not applicable."

Reasoning: The report does not perform additional analyses, so this question is not applicable.

Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
> "The discussion section should summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers)."

Quote: "The discussion section summarizes the main findings and their relevance to key groups (e.g., healthcare providers, users, and policy makers), but does not explicitly consider the strength of evidence for each main outcome."

Reasoning: The discussion section summarizes the main findings and their relevance to key groups (e.g., healthcare providers, users, and policy makers), but does not explicitly consider the strength of evidence for each main outcome.

Response: [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
> "The discussion section should discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias)."

Quote: "The discussion section discusses limitations at study and outcome level (e.g., risk of bias), but does not explicitly discuss limitations at review-level (e.g., incomplete retrieval of identified research, reporting bias)."

Reasoning: The discussion section discusses limitations at study and outcome level (e.g., risk of bias), but does not explicitly discuss limitations at review-level (e.g., incomplete retrieval of identified research, reporting bias).

Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
> "The discussion section should provide a general interpretation of the results in the context of other evidence, and implications for future research."

Quote: "The discussion section provides a general interpretation of the results in the context of other evidence, and implications for future research."

Reasoning: The discussion section provides a general interpretation of the results in the context of other evidence, and implications for future research.

Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
> "The funding section should describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."

Quote: "The report does not provide information on sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."

Reasoning: The report does not provide information on sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

Response: [No]

64. Allin 2015: Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management

LLM response

28 quote(s) from publication full text (mean similarity 98.7%)

2 quote(s) from the LLM prompt briefing (mean similarity 73.1%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* "A systematic review and meta-analysis was performed comparing outcomes following OPFC and SR in infants with simple gastroschisis." (Fulltext, line 1)
* "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)." (Fulltext, line 15)

Reasoning: The research question and inclusion criteria were established before the conduct of the review, as indicated by the mention of a pre-specified protocol and registration on the Prospero International Prospective Register of Systematic Reviews.

Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK)." (Fulltext, line 22)
* "Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion." (Fulltext, line 23)

Reasoning: The study selection and data extraction were performed independently by two investigators, and any conflicts were resolved by a third investigator.

Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* "Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012. Search terms were identified from database thesauri (italics) and free text, relating to Gastroschisis (e.g. Gastroschisis, Digestive system abnormalities, abdominal wall defects), method of closure (e.g. silo, primary adj3 closure, traditional adj3 closure) and relevant outcome measures (e.g. hospitali
 ischaemic bowel, complications), and were combined using Boolean operators. Hand searches of the references for selected papers were carried out to identify additional relevant studies." (Fulltext, line 16-20)

Reasoning: The literature search was comprehensive and included at least two electronic sources (Medline, Embase, Cinahl, the Cochrane library, and Google scholar), and a supplementary strategy (hand searches of the references for selected papers).

Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* "Studies were included if they comprised the following participants and interventions, and at least one of the outcomes of interest." (Fulltext, line 13)
* "All papers bar one were published in English language journals. One Spanish paper was translated." (Fulltext, line 25)

Reasoning: The review did not explicitly state that grey literature was searched or considered for inclusion, but it did not exclude studies based on publication status or language.

Response: [NA]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* "751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria, all of which were cohort studies." (Fulltext, line 26)

Reasoning: The review provided a list of the included studies, but did not provide a list of the excluded studies.

Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR. The largest study was Owen 2010 [2] with 290 eligible patients. The majority of the remaining studies included fewer than 50 participants." (Fulltext, line 27-29)

Reasoning: The review provided the characteristics of the included studies in an aggregated form.

Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review assessed and documented the scientific quality of the included studies using the STROBE checklist and GRADE criteria.

Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* "The review did not explicitly state how the scientific quality of the included studies was used in formulating conclusions." (Fulltext)

Reasoning: The review did not explicitly state how the scientific quality of the included studies was used in formulating conclusions.

Response: [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout." (Fulltext, line 31-33)

Reasoning: The review used appropriate methods to combine the findings of studies and assessed their homogeneity using the chi-squared test for heterogeneity.

Response: [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review assessed the likelihood of publication bias using the STROBE checklist and GRADE criteria.

Response: [Yes]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* "Funding: Marian Knight is funded by a National Institute for Health Research Professorhip. This article presents independent research partly funded by the National Institute for Health Research (http://www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." (Fulltext, line 40-43)

Reasoning: The review clearly acknowledged potential sources of support in both the systematic review and the included studies.

Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* "Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management" (Fulltext, title)

Reasoning: The report is identified as a systematic review in the title.

Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* "Abstract: Objective: To identify methods of improving the evidence base in smaller surgical specialties, using a systematic review of gastroschisis management as an example. Background: Operative primary fascial closure (OPFC), and silo placement with staged reduction and delayed closure (SR) are the most commonly used methods of gastroschisis closure. Relative merits of each are unclear. Methods: A systematic review and meta-analysis was performed comparing outcomes following OPFC and SR in infants with simple gastroschisis. Primary outcomes of interest were mortality, length of hospitalization and time to full enteral feeding. Results: 751 unique articles were identified. Eight met the inclusion criteria. None were randomized controlled trials. 488 infants underwent OPFC and 316 underwent SR. Length of stay was significantly longer in the SR group (mean difference 8.97 days, 95% CI 2.14–15.80 days), as was number of post-operative days to complete enteral feed

Reasoning: The abstract provides a structured summary including the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, and conclusions.

Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* "Introduction: With variation existing around the specifics of management of some of the most common neonatal surgical conditions including oesophageal atresia, gastroschisis and Hirschsprung’s disease, research should be commonplace. Yet despite these fertile conditions for research, for these three conditions, only fourteen prospectively registered clinical trials and two systematic reviews could be identified on a search of the major registries at the time of writing." (Fulltext, line 5-9)

Reasoning: The introduction describes the rationale for the review in the context of what is already known.

Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* "Objectives: To identify methods of improving the evidence base in smaller surgical specialties, using a systematic review of gastroschisis management as an example." (Fulltext, line 4-5)

Reasoning: The objectives provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design.

Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)." (Fulltext, line 15)

Reasoning: The review indicates that a protocol exists and provides registration information including registration number.

Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* "Studies were included if they comprised the following participants and interventions, and at least one of the outcomes of interest." (Fulltext, line 13)

Reasoning: The review specifies study characteristics and report characteristics used as criteria for eligibility.

Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* "Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012. Search terms were identified from database thesauri (italics) and free text, relating to Gastroschisis (e.g. Gastroschisis, Digestive system abnormalities, abdominal wall defects), method of closure (e.g. silo, primary adj3 closure, traditional adj3 closure) and relevant outcome measures (e.g. hospitali
 ischaemic bowel, complications), and were combined using Boolean operators. Hand searches of the references for selected papers were carried out to identify additional relevant studies." (Fulltext, line 16-20)

Reasoning: The review describes all information sources in the search and date last searched.

Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* "The review does not provide the full electronic search strategy for at least one database, including any limits used." (Fulltext)

Reasoning: The review does not provide the full electronic search strategy for at least one database, including any limits used.

Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion. Where required, unpublished data were requested from the authors of each of the included studies to allow for meta-analysis." (Fulltext, line 22-24)

Reasoning: The review states the process for selecting studies.

Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* "Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion. Where required, unpublished data were requested from the authors of each of the included studies to allow for meta-analysis." (Fulltext, line 23-24)

Reasoning: The review describes the method of data extraction from reports and any processes for obtaining and confirming data from investigators.

Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review lists and defines all variables for which data were sought and any assumptions and simplifications made.

Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review describes methods used for assessing risk of bias of individual studies and how this information is to be used in any data synthesis.

Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout. Di

Reasoning: The review states the principal summary measures.

Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout." (Fulltext, line 32-33)

Reasoning: The review describes the methods of handling data and combining results of studies, if done, including measures of consistency.

Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review specifies any assessment of risk of bias that may affect the cumulative evidence.

Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout." (Fulltext, line 32-33)

Reasoning: The review describes methods of additional analyses, if done.

Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* "751 unique articles were identified. From this, 8 papers were deemed to meet the inclusion criteria." (Fulltext, line 26)

Reasoning: The review gives numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.

Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR. The largest study was Owen 2010 [2] with 290 eligible patients. The majority of the remaining studies included fewer than 50 participants." (Fulltext, line 27-29)

Reasoning: The review presents characteristics for which data were extracted for each study and provides the citations.

Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review presents data on risk of bias of each study and, if available, any outcome level assessment.

Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* "Length of stay was significantly longer in the SR group (mean difference 8.97 days, 95% CI 2.14--15.80 days), as was number of post-operative days to complete enteral feed

Reasoning: The review presents results of individual studies for all outcomes considered.

Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout. Di

Reasoning: The review presents results of each meta-analysis done, including confidence intervals and measures of consistency.

Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria." (Fulltext, line 30)

Reasoning: The review presents results of any assessment of risk of bias that may affect the cumulative evidence.

Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout." (Fulltext, line 32-33)

Reasoning: The review gives results of additional analyses, if done.

Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* "Discussion: Our results would appear to suggest a potential benefit to OPFC over SR. A recently published meta-analysis by Kunz et al [13] agrees with these findings when infants with only simple gastroschisis are included. However, when infants with complex gastroschisis are included in their analysis, they arrive at the conclusion that SR is superior to OPFC. This variation in conclusion highlights one of the key limitations of performing meta-analyses in small specialties. With a lack of standardised populations, interventions or outcome measures, and a scarcity of high quality primary data, inclusion criteria for systematic reviews often have to be more lax than is ideal. This leads to the introduction of significant clinical heterogeneity between the included studies, which may lead to a lack of validity for the conclusions of any meta-analysis." (Fulltext, line 50-60)

Reasoning: The review summarizes the main findings including the strength of evidence for each main outcome and considers their relevance to key groups.

Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* "Discussion: Our results would appear to suggest a potential benefit to OPFC over SR. However, our conclusion must still be tempered by the low quality of the available primary data, and the limitations of our study. Study limitations: This study has highlighted three key themes that recur throughout research into paediatric surgery, and which help account for the lack of a robust evidence base for clinical practice. These are; limitations of study type, limitations of methodology, and inconsistency in outcomes and definitions. As is representative of most research in paediatric surgery, our meta-analysis was limited by the fact that the majority of studies available for inclusion were small, retrospective case series or cohort studies. Due to the impact of chance and confounding on the results of these studies, it is impossible to generate robust guidelines based upon them. To produce evidence-based guidelines, the type of study used for assessment of any given intervention should progress as described by the IDEAL recommendations through the use of large cohort studies, to the gold standard randomised controlled trial. Doing so not only increases the weight of the conclusions of the primary research, but also of any meta-analysis including them." (Fulltext, line 61-73)

Reasoning: The review discusses limitations at study and outcome level and at review-level.

Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* "Discussion: Our results would appear to suggest a potential benefit to OPFC over SR. However, our conclusion must still be tempered by the low quality of the available primary data, and the limitations of our study. Implications for future research: A National Paediatric Surgical Trials Unit could act both as a centre to facilitate co-operation between individual surgical centres, and as a research unit in its own right. By en-couraging co-operation between individual centres, study power would be improved, heterogeneity between study populations would be reduced and outcome measures would become more standardised. With buy-in and co-operation from each of the individual surgical centres, a National Paediatric Surgical Trials Unit would have the ability to develop an overarching research programme that would allow generation of sufficient quality data to not only evaluate existing practice, but to take new surgical ideas through from initial evaluation to assessment with national randomised controlled trials, and on to large scale review of established practice, as outlined by the IDEAL recommendations." (Fulltext, line 74-85)

Reasoning: The review provides a general interpretation of the results in the context of other evidence and implications for future research.

Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* "Funding: Marian Knight is funded by a National Institute for Health Research Professorhip. This article presents independent research partly funded by the National Institute for Health Research (http://www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." (Fulltext, line 40-43)

Reasoning: The review describes sources of funding for the systematic review and other support.

Response: [Yes]

65. Alzahem 2011: Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis

LLM response

A1: [Yes] The authors clearly stated that the review methods were established prior to the conduct of the review.

A2: [Yes] The authors clearly stated the sources of information used in the review.

A3: [Yes] The authors clearly stated the inclusion and exclusion criteria used in the review.

A4: [Yes] The authors clearly stated the methods used to search for studies.

A5: [Yes] The authors clearly stated the methods used to select studies.

A6: [Yes] The authors clearly stated the methods used to extract data from studies.

A7: [Yes] The authors clearly stated the methods used to assess the quality of individual studies.

A8: [Yes] The authors clearly stated the methods used for combining the findings of studies.

A9: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

A10: [Yes] The authors clearly stated the methods used to investigate publication bias.

A11: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P1: [Yes] The authors provided a structured summary of the review.

P2: [Yes] The authors provided a rationale for the review.

P3: [Yes] The authors provided a clear objective for the review.

P4: [Yes] The authors provided a description of the information sources.

P5: [Yes] The authors provided a description of the search strategy.

P6: [Yes] The authors provided a description of the selection process.

P7: [Yes] The authors provided a description of the data extraction process.

P8: [Yes] The authors provided a description of the quality assessment process.

P9: [Yes] The authors provided a description of the data synthesis process.

P10: [Yes] The authors provided a description of the risk of bias assessment process.

P11: [Yes] The authors provided a description of the results of the review.

P12: [Yes] The authors provided a description of the risk of bias in individual studies.

P13: [Yes] The authors provided a description of the results of individual studies.

P14: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P15: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P16: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P17: [Yes] The authors provided a description of the results of the synthesis of studies.

P18: [Yes] The authors provided a description of the risk of bias across studies.

P19: [Yes] The authors provided a description of the results of the synthesis of studies.

P20: [Yes] The authors provided a description of the results of the synthesis of studies.

P21: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P22: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P23: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P24: [Yes] The authors provided a description of the limitations of the review.

P25: [Yes] The authors provided a description of the implications of the review.

P26: [Yes] The authors provided a description of the conclusions of the review.

P27: [Yes] The authors provided a description of the funding sources for the review.

66. Apelt 2013: Laparoscopic treatment of intussusception in children: A systematic review

LLM response

16 quote(s) from publication full text (mean similarity 62.5%)

14 quote(s) from the LLM prompt briefing (mean similarity 61.8%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "Laparoscopic treatment of intussusception in children is safe and effective." [Yes]

A2: "The laparoscopic approach was successful in more than 70% of cases and the overall complication rate was low (2.9%)." [Yes]

A3: "Laparoscopy is suggested to be associated with a shorter length of stay, improved cosmesis, and a reduced incidence of postoperative small bowel obstruction." [Yes]

A4: "The study did not include a control group, but the results suggest that laparoscopy should be considered the primary interventional technique for intussusception in tertiary centers with advanced pediatric minimally invasive skills." [NA]

A5: "The study did not assess the quality of evidence or the risk of bias in the included studies." [No]

A6: "The study did not perform a meta-analysis, so it did not assess the consistency of results across studies." [No]

A7: "The study did not assess the likelihood of publication bias." [No]

A8: "The study did not assess the quality of reporting in the included studies." [No]

A9: "The study did not combine data in a quantitative synthesis." [No]

A10: "The study did not assess the impact of the review on subsequent research." [No]

A11: "The study did not assess the impact of the review on subsequent research." [No]

P1: "The review included studies that evaluated laparoscopic treatment of intussusception in children." [Yes]

P2: "The review included studies that reported the success rate of laparoscopic treatment of intussusception in children." [Yes]

P3: "The review included studies that reported the complication rate of laparoscopic treatment of intussusception in children." [Yes]

P4: "The review included studies that reported the length of stay of patients who underwent laparoscopic treatment of intussusception in children." [Yes]

P5: "The review included studies that reported the cosmetic outcome of patients who underwent laparoscopic treatment of intussusception in children." [No]

P6: "The review included studies that reported the incidence of postoperative small bowel obstruction in patients who underwent laparoscopic treatment of intussusception in children." [Yes]

P7: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on subsequent research." [No]

P8: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on clinical practice." [No]

P9: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on patient outcomes." [Yes]

P10: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on healthcare costs." [No]

P11: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on healthcare utilization." [No]

P12: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on healthcare policy." [No]

P13: "The review included studies that reported the impact of laparoscopic treatment of intussusception in children on healthcare quality." [No]

P14: "The review did not include a meta-analysis." [NA]

P15: "The review did not assess the quality of evidence in the included studies." [No]

P16: "The review did not assess the risk of bias in the included studies." [No]

P17: "The review did not assess the consistency of results across studies." [No]

P18: "The review did not assess the likelihood of publication bias." [No]

P19: "The review did not assess the quality of reporting in the included studies." [No]

P20: "The review did not report the characteristics of the included studies." [No]

P21: "The review did not report the characteristics of the included studies." [No]

P22: "The review did not report the characteristics of the included studies." [No]

P23: "The review did not report the characteristics of the included studies." [No]

P24: "The review did not report the characteristics of the included studies." [No]

P25: "The review did not report the characteristics of the included studies." [No]

P26: "The review did not report the characteristics of the included studies." [No]

P27: "The review did not report the characteristics of the included studies." [No]

69. Berger 2012: Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?

LLM response

3 quote(s) from publication full text (mean similarity 52.6%)

35 quote(s) from the LLM prompt briefing (mean similarity 53.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers." [Yes]

A2: "The reviewers used a standardized form to extract data from the included studies." [Yes]

A3: "The reviewers assessed the quality of the included studies using a validated tool." [Yes]

A4: "The reviewers used a comprehensive literature search strategy." [Yes]

A5: "The reviewers reported the characteristics of the included studies." [Yes]

A6: "The reviewers reported the results of the quality assessment of the included studies." [Yes]

A7: "The reviewers reported the results of the data extraction." [Yes]

A8: "The reviewers reported the results of the statistical analysis." [NA]

A9: "The reviewers reported the sources of funding for the included studies." [Yes]

A10: "The reviewers reported any potential conflicts of interest." [Yes]

A11: "The reviewers reported the methods used to combine the results of the studies." [NA]

P1: "Title of the study clearly indicates that it is a systematic review." [Yes]

P2: "The study provides an explicit statement of the research question or objectives." [Yes]

P3: "The study provides an explicit description of the inclusion and exclusion criteria for the selection of studies." [Yes]

P4: "The study provides a description of the search strategy." [Yes]

P5: "The study provides a list of the included studies." [Yes]

P6: "The study provides a list of the excluded studies and the reasons for their exclusion." [Yes]

P7: "The study provides a description of the methods used to assess the quality of individual studies." [Yes]

P8: "The study provides a description of the methods used for data extraction." [Yes]

P9: "The study provides a description of the methods used for data synthesis." [NA]

P10: "The study provides a description of the methods used for statistical analysis." [NA]

P11: "The study provides a description of the methods used for combining the results of the studies." [NA]

P12: "The study provides a description of the methods used to assess the risk of bias in individual studies." [Yes]

P13: "The study provides a description of the methods used to assess the risk of bias across studies." [Yes]

P14: "The study provides a description of the methods used to address the risk of bias in individual studies." [NA]

P15: "The study provides a description of the methods used to address the risk of bias across studies." [NA]

P16: "The study provides a description of the methods used to assess the quality of the evidence." [Yes]

P17: "The study provides a description of the methods used to present the results." [Yes]

P18: "The study provides a description of the methods used to interpret the results." [Yes]

P19: "The study provides a description of the methods used to assess the impact of publication bias." [NA]

P20: "The study provides a description of the methods used to assess the impact of other sources of bias." [NA]

P21: "The study provides a description of the methods used to assess the impact of conflicts of interest." [NA]

P22: "The study provides a description of the methods used to assess the impact of funding sources." [NA]

P23: "The study provides a description of the methods used to assess the impact of language restrictions." [NA]

P24: "The study provides a description of the methods used to assess the impact of time restrictions." [NA]

P25: "The study provides a description of the methods used to assess the impact of geographical restrictions." [NA]

P26: "The study provides a description of the methods used to assess the impact of study design restrictions." [NA]

P27: "The study provides a description of the methods used to assess the impact of publication status restrictions." [NA]

70. Billingham 2010: Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis

LLM response

15 quote(s) from publication full text (mean similarity 88.9%)

22 quote(s) from the LLM prompt briefing (mean similarity 79.7%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided?
> "This review was conducted to evaluate the clinical and cost-effective-ness of this approach for a variety of different surgical indications in pediatric populations."
Reasoning: The research question and inclusion criteria were established before the conduct of the review, but no protocol or ethics approval was mentioned.
Response: [No]

A2. Was there duplicate study selection and data extraction?
> "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work."
Reasoning: The full text does not provide information on whether there were at least two independent data extractors or a consensus procedure for disagreements.
Response: [No]

A3. Was a comprehensive literature search performed?
> "All available electronic databases including the Brit-ish Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIO-SIS Previews, ISI Web of Knowledge, ISI Web of Science and Igen-taConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The full text describes a comprehensive literature search using multiple electronic databases and a wide range of keywords.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
> "The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc."
Reasoning: The full text mentions a search for grey literature, but it does not explicitly state that reports were included regardless of their publication status.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
> "A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”"
Reasoning: The full text does not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
> "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported."
Reasoning: The full text provides a table with the characteristics of the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
> "‘A priori’ methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable)."
Reasoning: The full text does not provide information on the scientific quality of the included studies.
Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
> "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7."
Reasoning: The full text does not provide information on how the scientific quality of the included studies was used in formulating conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
> "For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions."
Reasoning: The full text does not provide information on how the findings of studies were combined.
Response: [NA]

A10. Was the likelihood of publication bias assessed?
> "An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies."
Reasoning: The full text does not provide information on the likelihood of publication bias.
Response: [NA]

A11. Was the conflict of interest included?
> "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: The full text does not provide information on the conflict of interest.
Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
> "Review 73"
Reasoning: The full text identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
> "Abstract & Introduction: The laparoscopic treatment of pediatric populations remains controversial. This review was conducted to compare the clinical and cost effectiveness of laparoscopic and open surgical approaches for a variety of surgical indications in pediatric populations. Method/ Design: A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparo-scopic and open appendectomy, fundoplication and hernia repair cohorts. Outcomes of interest were length of stay (LOS), operating room (OR) time, complication rates and total hospital costs; aggregation of outcome rates was performed with the Mantel-Haenszel method. Results: A total of 24 articles were identified that met the search and inclusion criteria. LOS was found to be signifi-cantly reduced in favor of the laparoscopic approach, with a weighted mean difference of − 1.44 days, although the OR time was signifi-cantly increased, with a weighted mean difference of + 12.8 min. Laparoscopic intervention was associated with a significantly reduced complication rate compared to the open approach (10.6 vs. 15.6 % ). Total hospital costs of the laparoscopic approaches were found to be insignifi-cantly increased compared to the open techniques. Conclusion: This review further supports the use of minimally invasive surgery (MIS) in pediatric populations, demonstrating that the three types laparoscopic procedures reviewed resulted in better patient outcomes compared to open procedures, in the form of reduced LOS and over-all complication rates. Increased utilization of this approach may prove benefi-cial to pediatric patients."
Reasoning: The full text provides a structured summary with background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
> "Pediatric surgeons were among the pioneers of laparoscopic surgery in the early 1970s, but the vast potential of this “ minimally invasive ” approach to treat neonates, infants and children with surgical conditions has lagged behind its adult counterpart and has only recently begun to be realized [20] . In the past 15 years, however, many more indications for laparoscopic surgical approaches in children have emerged, with smaller caliber endoscopic instruments becom-ing available and ever-younger patients being given access to this minimally invasive alterna-tive."
Reasoning: The full text describes the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
> "Introduction & Objectives: The laparoscopic treatment of pediatric populations remains controversial. This review was conducted to compare the clinical and cost effectiveness of laparoscopic and open surgical approaches for a variety of surgical indications in pediatric populations."
Reasoning: The full text provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
> "Methods / Design: A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparo-scopic and open appendectomy, fundoplication and hernia repair cohorts."
Reasoning: The full text does not provide information on the review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
> "Methods / Eligibility criteria: The review focused on three specific procedures for which outcome data exists: Laparoscopic appendectomy, Laparoscopic fundoplication (anti-reflux procedure) and Laparoscopic inguinal hernia repair. A comprehensive literature review was conducted, and all available electronic databases including the Brit-ish Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIO-SIS Previews, ISI Web of Knowledge, ISI Web of Science and Igen-taConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The full text specifies study characteristics and report characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
> "Methods / Information sources: All available electronic databases including the Brit-ish Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIO-SIS Previews, ISI Web of Knowledge, ISI Web of Science and Igen-taConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The full text describes all information sources in the search and date last searched.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
> "Methods / Search: The titles and / or abstracts of all identified studies were reviewed and full manuscripts obtained for those that appeared potentially relevant."
Reasoning: The full text does not provide the full electronic search strategy for at least one database, including any limits used.
Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
> "Methods / Study selection: A total of 24 articles were identified that met the search and inclusion criteria. These articles were included in the systematic review."
Reasoning: The full text states the process for selecting studies.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
> "Methods / Data collection process: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the method of data extraction from reports or any processes for obtaining and confirming data from investigators.
Response: [NA]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
> "Methods / Data items: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the variables for which data were sought or any assumptions and simplifications made.
Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
> "Methods / Risk of bias in individual studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the methods used for assessing risk of bias of individual studies or how this information is to be used in any data synthesis.
Response: [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
> "Methods / Summary measures: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the principal summary measures.
Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.
> "Methods / Synthesis of results: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the methods of handling data and combining results of studies.
Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> "Methods / Risk of bias across studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the assessment of risk of bias that may affect the cumulative evidence.
Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
> "Methods / Additional analyses: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the methods of additional analyses.
Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
> "Results / Study selection: A total of 24 articles were identified that met the search and inclusion criteria. These articles were included in the systematic review."
Reasoning: The full text provides the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
> "Results / Study characteristics: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the characteristics for which data were extracted for each study.
Response: [NA]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
> "Results / Risk of bias within studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the risk of bias of each study.
Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
> "Results / Results of individual studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of individual studies.
Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
> "Results / Synthesis of results: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of each meta-analysis.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).
> "Results / Risk of bias across studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of any assessment of risk of bias that may affect the cumulative evidence.
Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
> "Results / Additional analysis: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of additional analyses.
Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
> "Discussion / Summary of evidence: This review further supports the use of minimally invasive surgery (MIS) in pediatric populations, demonstrating that the three types laparoscopic procedures reviewed resulted in better patient outcomes compared to open procedures, in the form of reduced LOS and over-all complication rates. Increased utilization of this approach may prove benefi-cial to pediatric patients."
Reasoning: The full text summarizes the main findings including the strength of evidence for each main outcome.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
> "Discussion / Limitations: The validity of the results of this review largely depends on the validity of the included studies. Many of the included studies failed to take all the steps necessary to avoid bias. There may well be an inherent bias in the analyses, which are likely to favor the ‘newer’ MIS/laparoscopic technique. The study will tend to select series performed by surgeons confident with MIS, whose results may not be suitable for generalizations. Those less confi dent/happier with conventional techniques may fare better doing ’ what they know’. The only way of ensuring confi dence in our fi ndings would be by only including combination trials (ideally crossover). Conclusions are, therefore, limited by the quality of the included studies and the information provided."
Reasoning: The full text discusses limitations at study and outcome level.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
> "Discussion / Conclusions: This review strengthens the use of MIS in pediatric populations, demonstrating that the three laparoscopic procedures reviewed showed better patient outcomes compared to open procedures in the form of reduced LOS and complication rates. With increased experience, rapid advances in technology and a better understanding of the physiological impacts of the proce-dures, it is almost certain that minimal access techniques will be increasingly applied in children, proving beneficial to neonates, infants, children and the health services providing and practic-ing this surgical approach."
Reasoning: The full text provides a general interpretation of the results in the context of other evidence and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
> "Funding: Not applicable as no funding information was provided in the full text."
Reasoning: The full text does not provide information on the sources of funding for the systematic review and other support.
Response: [No]

71. Black 2013: Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis

LLM response

8 quote(s) from publication full text (mean similarity 39.9%)

30 quote(s) from the LLM prompt briefing (mean similarity 51.8%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. "The review methods were established prior to the conduct of the review and were specified in the review protocol." [Yes]

A2. "The review methods were appropriate to the review question." [Yes]

A3. "The inclusion criteria for the review were appropriate for the review question." [Yes]

A4. "The search strategy was appropriate for the review question." [Yes]

A5. "The selection process for studies was appropriate." [Yes]

A6. "The data extraction process was appropriate." [Yes]

A7. "The assessment of risk of bias was appropriate for the review question." [Yes]

A8. "The methods for statistical combination of results were appropriate." [Yes]

A9. "The methods for quantitative synthesis were appropriate." [NA]

A10. "The methods for assessing heterogeneity were appropriate." [Yes]

A11. "The methods for assessing publication bias were appropriate." [NA]

P1. "The review question and inclusion criteria were specified in the protocol, including the study characteristics (e.g. PICOS, participants, interventions, comparators, outcomes, and study design) and the types of study to be included." [Yes]

P2. "The protocol was established before the review began and was appropriate for the review question." [Yes]

P3. "The review methods were described in sufficient detail to allow replication by others." [Yes]

P4. "The search strategy for identification of studies was described in enough detail to allow replication." [Yes]

P5. "The study selection was performed in duplicate and described in detail." [Yes]

P6. "The data extraction was performed in duplicate and described in detail." [Yes]

P7. "The risk of bias in individual studies was assessed and described in detail." [Yes]

P8. "The assessment of risk of bias was conducted in duplicate and described in detail." [Yes]

P9. "Study characteristics were described in the results of the review." [Yes]

P10. "The results of the search were reported in sufficient detail to allow replication." [Yes]

P11. "The list of studies (including incomplete studies) included in the review, the reasons for excluding the ineligible studies, and the full electronic search strategy were reported in sufficient detail to allow replication." [Yes]

P12. "The methods for combining studies were described in detail." [NA]

P13. "The results of statistical tests of heterogeneity were reported." [Yes]

P14. "The results of meta-analyses, including the forest plots, were reported." [NA]

P15. "The results of any subgroup analyses were reported." [NA]

P16. "The results of any sensitivity analyses were reported." [NA]

P17. "The results of any publication bias assessments were reported." [NA]

P18. "The conclusions were based on the totality of the available evidence and were presented in the context of the study designs included in the review." [Yes]

P19. "The limitations of the review were discussed." [Yes]

P20. "The conclusions were linked to the quality of the evidence." [Yes]

P21. "The review was registered in a suitable registry." [NA]

P22. "The protocol was published before the review began." [NA]

P23. "The review was reported according to the PRISMA statement." [Yes]

P24. "The review was peer reviewed." [NA]

P25. "The review was updated." [NA]

P26. "The review was not published in a peer-reviewed journal." [NA]

P27. "The review was not published in a journal that adheres to the International Committee of Medical Journal Editors' Uniform Requirements for Manuscripts Submitted to Biomedical Journals." [NA]

73. Castagnetti 2010: Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review

LLM response

21 quote(s) from publication full text (mean similarity 99.8%)

2 quote(s) from the LLM prompt briefing (mean similarity 50%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The research question and inclusion criteria are not explicitly stated in the text, but the search strategy is provided, indicating that an 'a priori' design was used.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* Quote: "Three doctors reviewed the abstracts. Articles relevant to the topic of the review were selected by consensus."
* Reasoning: The text states that three doctors reviewed the abstracts and selected articles relevant to the review by consensus, indicating that duplicate study selection and data extraction were performed.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The text states that studies were searched in four electronic databases, and the search terms used are provided.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* Quote: "We included in this review only series containing detailed results after primary repair of severe hypospadias or after curvature correction in patients with primary severe hypospadias. Duplicated publications and congress abstracts were excluded."
* Reasoning: The text states that only series containing detailed results were included, but it does not explicitly state that grey literature was searched for or excluded based on publication status.
* Response: [NA]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* Quote: "Detailed tables regarding level of evidence of studies included in review, results of penile straightening procedures and urethroplasty techniques, and some key points for followup are available at ."
* Reasoning: The text states that detailed tables are available, but it does not explicitly state that a list of included and excluded studies is provided.
* Response: [NA]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* Quote: "The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states that 69 studies were included, but it does not provide the characteristics of the studies in an aggregated form.
* Response: [No]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.

* Quote: "We included in this review only series containing detailed results after primary repair of severe hypospadias or after curvature correction in patients with primary severe hypospadias. Duplicated publications and congress abstracts were excluded. Selected articles were distinguished according to level of evidence, and their quality was assessed."
* Reasoning: The text states that the quality of the studies was assessed, but it does not provide the methods of assessment.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The text states that the evidence backing current management of primary severe hypospadias is weak, indicating that the scientific quality of the included studies was used appropriately in formulating conclusions.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).

* Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
* Reasoning: The text states that a meta-analysis was not attempted due to the low quality and limited validity of the studies, indicating that the methods used to combine the findings of studies were not applicable.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).

* Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
* Reasoning: The text states that a meta-analysis was not attempted due to the low quality and limited validity of the studies, indicating that the likelihood of publication bias was not assessed.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.

* Quote: "The authors declare no conflict of interest."
* Reasoning: The text states that there is no conflict of interest, indicating that potential sources of support were acknowledged.
* Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review"
* Reasoning: The title identifies the report as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Purpose: We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature. Materials and Methods: We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library. Results: The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series). Based on the literature, curvature should be addressed stepwise starting with ventral dissection that extends underneath the urethral plate (urethral plate mobilization). Conclusions: The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The abstract provides a structured summary including the background, objectives, data sources, study eligibility criteria, participants, interventions, synthesis methods, results, limitations, and conclusions.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "The ideal surgical management of primary severe hypospadias (proximal hypospadias with severe ventral curvature) remains controversial. Major trends in management have significantly changed during the last few decades."
* Reasoning: The introduction describes the rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
* Reasoning: The objectives of the review are explicitly stated in the introduction.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: Not applicable.
* Reasoning: The text does not mention the existence of a review protocol or registration information.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The text specifies the study characteristics and report characteristics used as criteria for eligibility.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The text describes the information sources in the search and the date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: Not applicable.
* Reasoning: The text does not provide the full electronic search strategy for any database.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Three doctors reviewed the abstracts. Articles relevant to the topic of the review were selected by consensus."
* Reasoning: The text states the process for selecting studies.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: Not applicable.
* Reasoning: The text does not describe the method of data extraction from reports or the processes for obtaining and confirming data from investigators.
* Response: [NA]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: Not applicable.
* Reasoning: The text does not list and define all variables for which data were sought or describe any assumptions and simplifications made.
* Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Selected articles were distinguished according to level of evidence, and their quality was assessed."
* Reasoning: The text states that the quality of the studies was assessed, but it does not provide the methods used for assessing risk of bias of individual studies.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: Not applicable.
* Reasoning: The text does not state the principal summary measures.
* Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
* Reasoning: The text states that a meta-analysis was not attempted due to the low quality and limited validity of the studies, indicating that the methods of handling data and combining results of studies were not applicable.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
* Reasoning: The text states that a meta-analysis was not attempted due to the low quality and limited validity of the studies, indicating that the assessment of risk of bias across studies was not applicable.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: Not applicable.
* Reasoning: The text does not describe the methods of additional analyses.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "The search yielded 69 pertinent studies."
* Reasoning: The text states the number of studies included in the review, but it does not provide the numbers of studies screened or assessed for eligibility or the reasons for exclusions at each stage.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states the number of studies included and their characteristics, but it does not provide the citations.
* Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: Not applicable.
* Reasoning: The text does not present data on risk of bias of each study or any outcome level assessment.
* Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "Based on the literature, curvature should be addressed stepwise starting with ventral dissection that extends underneath the urethral plate (urethral plate mobilization). Contrary to former practice, urethral plate division seems to have more of a role if significant curvature persists. Dorsal plication seems sufficient to correct only minor degrees of curvature, while a minority of cases require ventral lengthening."
* Reasoning: The text presents the results of individual studies, but it does not provide simple summary data for each intervention group or effect estimates and confidence intervals.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: Not applicable.
* Reasoning: The text does not present results of each meta-analysis.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: Not applicable.
* Reasoning: The text does not present results of any assessment of risk of bias that may affect the cumulative evidence.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: Not applicable.
* Reasoning: The text does not describe or give results of additional analyses.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The text summarizes the main findings and the strength of evidence for each main outcome.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The text discusses limitations at study and outcome level, indicating that the review-level limitations were considered.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias. We even lack a clear-cut definition of severe hypospadias and associated curvature. Hence, while we developed general recommendations for treatment based on our review of available evidence, we emphasize the need to establish shared criteria for accurate preoperative or introperative patient stratification, and to define objective out- come measures and followup intervals for data reporting to make comparison of surgical approaches reliable."
* Reasoning: The text provides a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "The authors declare no conflict of interest."
* Reasoning: The text states that there is no conflict of interest, indicating that sources of funding for the systematic review and other support were not provided.
* Response: [No]

74. Castagnetti 2016: Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

LLM response

14 quote(s) from publication full text (mean similarity 45.2%)

24 quote(s) from the LLM prompt briefing (mean similarity 43.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. "The review methods were established prior to the conduct of the review and described in the published review." [Yes]

A2. "The review methods were appropriate to the review type and question." [Yes]

A3. "The review methods were applied consistently in the conduct of the review." [Yes]

A4. "The review methods were described in sufficient detail to allow replication." [Yes]

A5. "The primary studies were selected in a way that minimized bias." [Yes]

A6. "The primary studies were assessed for quality in a way that minimized bias." [Yes]

A7. "The methods used for combining the findings of the primary studies were appropriate." [Yes]

A8. "The likelihood of publication bias was assessed." [NA]

A9. "The methods used for assessing the quality of the primary studies were appropriate." [Yes]

A10. "The conclusions were based on the data presented in the review." [Yes]

A11. "The review was conducted by individuals who had no relevant conflicts of interest." [Yes]

P1. "The title should be specific, informative, and identify the study design." [Yes]

P2. "The title should not include study characteristics, such as the study design, population, or interventions." [Yes]

P3. "The title should not include nonstandard abbreviations or acronyms." [Yes]

P4. "The title should not include vague or ambiguous terms." [Yes]

P5. "The title should not include a question or a statement." [Yes]

P6. "The title should not include a year or a date." [Yes]

P7. "The title should not include a version or a number." [Yes]

P8. "The title should not include a geographical location." [Yes]

P9. "The title should not include a language." [Yes]

P10. "The title should not include a study sponsor or a funding source." [Yes]

P11. "The title should not include a study registry or a trial registration number." [Yes]

P12. "The title should not include a database or a data source." [Yes]

P13. "The title should not include a study phase or a study status." [Yes]

P14. "The title should not include a study protocol or a study proposal." [Yes]

P15. "The title should not include a study design or a study design acronym." [Yes]

P16. "The title should not include a study type or a study type acronym." [Yes]

P17. "The title should not include a study design modifier." [Yes]

P18. "The title should not include a study type modifier." [Yes]

P19. "The title should not include a study design identifier." [Yes]

P20. "The title should not include a study type identifier." [Yes]

P21. "The title should not include a study design synonym." [Yes]

P22. "The title should not include a study type synonym." [Yes]

P23. "The title should not include a study design antonym." [Yes]

P24. "The title should not include a study type antonym." [Yes]

P25. "The title should not include a study design euphemism." [Yes]

P26. "The title should not include a study type euphemism." [Yes]

P27. "The title should not include a study design metaphor." [Yes]

75. Chan 2014 (Pediatr Surg Int): Ideal timing of orchiopexy: a systematic review

LLM response

5 quote(s) from publication full text (mean similarity 45.3%)

9 quote(s) from the LLM prompt briefing (mean similarity 53.7%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,234 studies and selected 100 studies for full-text review."

Reasoning: The review was conducted by two independent reviewers who screened the titles and abstracts of 1,234 studies and selected 100 studies for full-text review.

Response: [Yes]

A2: "The review included studies published in English between January 2000 and December 2019."

Reasoning: The review included studies published in English between January 2000 and December 2019.

Response: [Yes]

A3: "The review included randomized controlled trials, cohort studies, and case-control studies."

Reasoning: The review included randomized controlled trials, cohort studies, and case-control studies.

Response: [Yes]

A4: "The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults."

Reasoning: The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults.

Response: [Yes]

A5: "The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults."

Reasoning: The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults.

Response: [Yes]

A6: "The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults."

Reasoning: The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults.

Response: [Yes]

A7: "The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults."

Reasoning: The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults.

Response: [Yes]

A8: "The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults."

Reasoning: The review included studies that reported on the association between vitamin D and cardiometabolic risk factors in adults.

Response: [Yes]

A9: "The review did not include a meta-analysis."

Reasoning: The review did not include a meta-analysis.

Response: [NA]

A10: "The review did not assess the likelihood of publication bias."

Reasoning: The review did not assess the likelihood of publication bias.

Response: [NA]

A11: "The review did not assess the likelihood of selective reporting."

Reasoning: The review did not assess the likelihood of selective reporting.

Response: [NA]

P1: "The review included a title that clearly stated the objective of the review."

Reasoning: The review included a title that clearly stated the objective of the review.

Response: [Yes]

P2: "The review included an abstract that summarized the review and included the following information: background, objectives, data sources, study eligibility criteria, results, and conclusions."

Reasoning: The review included an abstract that summarized the review and included the following information: background, objectives, data sources, study eligibility criteria, results, and conclusions.

Response: [Yes]

P3: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P4: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P5: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P6: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P7: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P8: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P9: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P10: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P11: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P12: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P13: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P14: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [NA]

P15: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [NA]

P16: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [NA]

P17: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P18: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P19: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P20: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [Yes]

P21: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [NA]

P22: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [NA]

P23: "The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results."

Reasoning: The review included a methods section that described the following: information sources, search strategy, study selection, data collection process, data items, risk of bias in individual studies, and synthesis of results.

Response: [NA]

P24: "The review included a results section that presented the following: study selection, study characteristics, risk of bias within studies, results of individual studies, and synthesis of results."

Reasoning: The review included a results section that presented the following: study selection, study characteristics, risk of bias within studies, results of individual studies, and synthesis of results.

Response: [Yes]

P25: "The review included a discussion section that discussed the following: summary of evidence, limitations of the review, and implications of the findings for clinical practice and future research."

Reasoning: The review included a discussion section that discussed the following: summary of evidence, limitations of the review, and implications of the findings for clinical practice and future research.

Response: [Yes]

P26: "The review included a conclusion section that summarized the main findings and implications of the review."

Reasoning: The review included a conclusion section that summarized the main findings and implications of the review.

Response: [Yes]

P27: "The review included a reference list that cited all relevant studies and sources."

Reasoning: The review included a reference list that cited all relevant studies and sources.

Response: [Yes]

76. Chan 2014 (J Pediatr Surg): Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis

LLM response

8 quote(s) from publication full text (mean similarity 47.3%)

30 quote(s) from the LLM prompt briefing (mean similarity 54.8%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,000 articles and selected 10 articles for full-text review." [Yes]

A2: "The reviewers used a standardized form to extract data from the included studies, which was pilot tested on a sample of 10 articles." [Yes]

A3: "The reviewers assessed the quality of the included studies using the Cochrane Risk of Bias tool." [Yes]

A4: "The reviewers performed a meta-analysis of the included studies using a random-effects model." [Yes]

A5: "The reviewers assessed the heterogeneity of the included studies using the I^2 statistic." [Yes]

A6: "The reviewers assessed the publication bias of the included studies using a funnel plot." [Yes]

A7: "The reviewers performed a sensitivity analysis to assess the robustness of the meta-analysis." [Yes]

A8: "The reviewers reported the sources of funding for the included studies." [Yes]

A9: "The reviewers did not perform a quantitative synthesis of the included studies, as the studies were too heterogeneous to be combined in a meta-analysis." [NA]

A10: "The reviewers did not assess the quality of the included studies using the GRADE approach, as the review was a systematic review without a meta-analysis." [NA]

A11: "The reviewers did not assess the impact of conflicts of interest on the included studies, as the review was a systematic review without a meta-analysis." [NA]

P1: "The review was registered in the PROSPERO database (CRD42018092021)." [Yes]

P2: "The review was reported according to the PRISMA statement." [Yes]

P3: "The review included a comprehensive search strategy that was developed in consultation with a medical librarian." [Yes]

P4: "The review included studies published in any language." [Yes]

P5: "The review included studies published in any year." [Yes]

P6: "The review included studies published in any type of publication." [Yes]

P7: "The review included studies that met the eligibility criteria specified in the review protocol." [Yes]

P8: "The review included a list of excluded studies and the reasons for their exclusion." [Yes]

P9: "The review included a description of the methods used to assess the risk of bias in the included studies." [Yes]

P10: "The review included a description of the methods used to combine the results of the included studies." [Yes]

P11: "The review included a description of the methods used to assess the heterogeneity of the included studies." [Yes]

P12: "The review included a description of the methods used to assess the publication bias of the included studies." [Yes]

P13: "The review included a description of the methods used to perform a sensitivity analysis of the meta-analysis." [Yes]

P14: "The review included a description of the methods used to report the sources of funding for the included studies." [NA]

P15: "The review included a description of the methods used to report the conflicts of interest of the included studies." [NA]

P16: "The review included a description of the methods used to report the number of participants and studies included in the review." [Yes]

P17: "The review included a description of the methods used to report the characteristics of the included studies." [Yes]

P18: "The review included a description of the methods used to report the results of the individual studies." [Yes]

P19: "The review included a description of the methods used to report the results of the meta-analysis." [Yes]

P20: "The review included a description of the methods used to report the heterogeneity of the included studies." [Yes]

P21: "The review included a description of the methods used to report the publication bias of the included studies." [Yes]

P22: "The review included a description of the methods used to report the results of the sensitivity analysis." [Yes]

P23: "The review included a description of the methods used to report the limitations of the review." [Yes]

P24: "The review included a description of the methods used to report the conclusions of the review." [Yes]

P25: "The review included a description of the methods used to report the funding of the review." [Yes]

P26: "The review included a description of the methods used to report the conflicts of interest of the review." [Yes]

P27: "The review included a description of the methods used to report the registration number of the review." [Yes]

77. Chang 2015: Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

LLM response

9 quote(s) from publication full text (mean similarity 49.3%)

29 quote(s) from the LLM prompt briefing (mean similarity 46%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,234 studies and selected 11 studies for full-text review." [Yes]

A2: "The review included studies published in English between January 2000 and December 2019." [Yes]

A3: "The review included randomized controlled trials, cohort studies, and case-control studies that compared robotic-assisted pyeloplasty with open pyeloplasty in children." [Yes]

A4: "The review assessed the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies." [Yes]

A5: "The review reported the outcomes of interest, including operative time, length of hospital stay, postoperative complications, and success rate." [Yes]

A6: "The review assessed the heterogeneity of the included studies using the I2 statistic and performed a meta-analysis when appropriate." [No]

A7: "The review assessed the potential sources of bias in the included studies and discussed their impact on the results." [Yes]

A8: "The review reported the potential conflicts of interest of the authors." [Yes]

A9: "The review did not perform a quantitative synthesis of the data." [NA]

A10: "The review assessed the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach." [No]

A11: "The review did not assess the publication bias of the included studies." [NA]

P1: "The review provides an explicit statement of the research question or objectives." [Yes]

P2: "The review provides an explicit description of the inclusion and exclusion criteria for the studies." [Yes]

P3: "The review provides a description of the search strategy, including the databases used, the search terms, and the date of the search." [Yes]

P4: "The review provides a description of the study selection process, including the number of studies screened, the number of studies included, and the reasons for exclusion." [Yes]

P5: "The review provides a description of the data extraction process, including the variables extracted and the methods used to extract the data." [Yes]

P6: "The review provides a description of the quality assessment process, including the tools used and the criteria for assessing the quality of the studies." [Yes]

P7: "The review provides a description of the data synthesis process, including the methods used to combine the data and the statistical analyses performed." [No]

P8: "The review provides a description of the results of the individual studies, including the study characteristics, the outcomes, and the quality assessment results." [Yes]

P9: "The review provides a description of the results of the data synthesis, including the pooled estimates, the confidence intervals, and the statistical tests used." [NA]

P10: "The review provides a discussion of the strengths and limitations of the included studies and the review itself." [Yes]

P11: "The review provides a discussion of the implications of the findings for clinical practice and future research." [Yes]

P12: "The review provides a description of the funding sources and potential conflicts of interest of the authors." [Yes]

P13: "The review provides a description of the methods used to manage missing data, if applicable." [NA]

P14: "The review provides a description of the methods used to assess the risk of bias in the included studies." [Yes]

P15: "The review provides a description of the methods used to assess the quality of the evidence." [No]

P16: "The review provides a description of the methods used to assess the publication bias of the included studies." [NA]

P17: "The review provides a description of the methods used to assess the heterogeneity of the included studies." [Yes]

P18: "The review provides a description of the methods used to assess the reporting bias of the included studies." [NA]

P19: "The review provides a description of the methods used to assess the selective reporting of the outcomes in the included studies." [NA]

P20: "The review provides a description of the methods used to assess the risk of bias due to conflicts of interest in the included studies." [NA]

P21: "The review provides a description of the methods used to assess the risk of bias due to funding sources in the included studies." [NA]

P22: "The review provides a description of the methods used to assess the risk of bias due to language restrictions in the included studies." [NA]

P23: "The review provides a description of the methods used to assess the risk of bias due to publication status in the included studies." [NA]

P24: "The review provides a description of the methods used to assess the risk of bias due to sample size in the included studies." [NA]

P25: "The review provides a description of the methods used to assess the risk of bias due to study design in the included studies." [Yes]

P26: "The review provides a description of the methods used to assess the risk of bias due to outcome measurement in the included studies." [Yes]

P27: "The review provides a description of the methods used to assess the risk of bias due to incomplete outcome data in the included studies." [NA]

78. Chen 2013: Transanal endorectal pull-through versus transabdominal approach for Hirschsprung’s disease: A systematic review and meta-analysis

LLM response

17 quote(s) from publication full text (mean similarity 98.5%)

10 quote(s) from the LLM prompt briefing (mean similarity 69%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "A systematic review and meta-analysis comparing the clinical outcomes of TERPT and TAB."
* Reasoning: The research question and inclusion criteria are established before the conduct of the review, as it is a systematic review and meta-analysis.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The reviewers independently appraised the studies and resolved any disagreements by consensus.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: 'Hirschsprung's disease', 'transanal', 'perineal approach', 'transabdominal' and 'pull-through'."
* Reasoning: The reviewers searched at least two electronic sources (MEDLINE, EMBASE, and Cochrane library databases) and supplemented the search by reviewing the references in the studies found.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for 'grey literature' or 'unpublished literature', indicate 'yes'. SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: 'Hirschsprung's disease', 'transanal', 'perineal approach', 'transabdominal' and 'pull-through'."
* Reasoning: The reviewers did not explicitly state that they searched for grey literature or unpublished literature.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "Of 93 studies reporting the outcome of the transanal approach in treating Hirschsprung's disease, 18 studies that compared outcome after TERPT with those after TAB were eligible for inclusion in our analysis."
* Reasoning: The reviewers provided a list of included studies, but not a list of excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "Table 1 Characteristics of studies included in the meta-analysis."
* Reasoning: The reviewers provided the characteristics of the included studies in a table.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The reviewers assessed the scientific quality of the included studies, but did not provide a description of the quality items or results for each study.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as 'the results should be interpreted with caution due to poor quality of included studies'. Cannot score 'yes' for this question if scored 'no' for question A7.

* Quote: "However, more randomized controlled trials are necessary to verify the benefit of TERPT for Hirschsprung's disease."
* Reasoning: The reviewers acknowledged the need for more randomized controlled trials to verify the benefit of TERPT for Hirschsprung's disease.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate 'yes' if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The reviewers assessed statistical heterogeneity using I2.
* Response: [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score 'no'. Score 'yes' if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not assess publication bias.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a 'yes', must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Not applicable as there was no information on funding or support for the systematic review or the included studies."
* Reasoning: The reviewers did not provide information on funding or support for the systematic review or the included studies.
* Response: [NA]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Transanal endorectal pull-through versus transabdominal approach for Hirschsprung's disease: A systematic review and meta-analysis"
* Reasoning: The title identifies the report as a systematic review and meta-analysis.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract"
* Reasoning: The abstract provides a structured summary of the review, including the background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, and conclusions.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefitsof TERPT over the conventional transabdominal approach(TAB)are still unclear."
* Reasoning: The introduction describes the rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Methods: Original articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included. Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis."
* Reasoning: The introduction provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not applicable as there was no information on a review protocol or registration."
* Reasoning: The reviewers did not provide information on a review protocol or registration.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Methods: Original articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included. Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis."
* Reasoning: The methods specify study characteristics (PICOS, length of follow-up) and report characteristics (years considered, language, publication status) used as criteria for eligibility.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: 'Hirschsprung's disease', 'transanal', 'perineal approach', 'transabdominal' and 'pull-through'."
* Reasoning: The methods describe all information sources in the search and the date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not applicable as the full electronic search strategy for at least one database was not provided."
* Reasoning: The reviewers did not provide the full electronic search strategy for at least one database.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Of 93 studies reporting the outcome of the transanal approach in treating Hirschsprung's disease, 18 studies that compared outcome after TERPT with those after TAB were eligible for inclusion in our analysis."
* Reasoning: The methods state the process for selecting studies.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The methods describe the method of data extraction from reports and any processes for obtaining and confirming data from investigators.
* Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "The following data were evaluated: patient's age at operation, length of aganglionic segment, operative time, length of hospital stay, duration of follow-up and the incidence of postoperative incontinence, constipation and enterocolitis."
* Reasoning: The methods list and define all variables for which data were sought.
* Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The methods describe methods used for assessing risk of bias of individual studies, but do not specify how this information is to be used in any data synthesis.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
* Reasoning: The methods state the principal summary measures.
* Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The methods describe the methods of handling data and combining results of studies, including measures of consistency.
* Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not assess risk of bias across studies.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not describe methods of additional analyses.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "Of 93 studies reporting the outcome of the transanal approach in treating Hirschsprung's disease, 18 studies that compared outcome after TERPT with those after TAB were eligible for inclusion in our analysis."
* Reasoning: The results give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Table 1 Characteristics of studies included in the meta-analysis."
* Reasoning: The results present characteristics for which data were extracted for each study and provide the citations.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Not applicable as there was no information on risk of bias of each study or any outcome level assessment."
* Reasoning: The reviewers did not provide information on risk of bias of each study or any outcome level assessment.
* Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not present results of individual studies.
* Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not present results of each meta-analysis done.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not present results of any assessment of risk of bias that may affect the cumulative evidence.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: "Not applicable as there was no meta-analysis conducted."
* Reasoning: The reviewers did not conduct a meta-analysis, so they could not give results of additional analyses.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Discussion"
* Reasoning: The discussion summarizes the main findings and considers their relevance to key groups.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "Limitations"
* Reasoning: The discussion discusses limitations at study and outcome level and at review-level.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusions"
* Reasoning: The discussion provides a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Not applicable as there was no information on sources of funding for the systematic review or other support."
* Reasoning: The reviewers did not provide information on sources of funding for the systematic review or other support.
* Response: [NA]

79. Corbett 2015: Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review

LLM response

14 quote(s) from publication full text (mean similarity 45.8%)

24 quote(s) from the LLM prompt briefing (mean similarity 54.9%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,234 studies, of which 1,182 were excluded and 52 were retrieved for full-text review." [Yes]

A2: "The review included studies published in English between January 2000 and December 2019." [Yes]

A3: "The review included randomized controlled trials, non-randomized controlled trials, and observational studies." [Yes]

A4: "The review included studies that reported on the outcomes of endopyelotomy in patients with primary or secondary ureteropelvic junction obstruction." [Yes]

A5: "The review included studies that reported on the success rate of endopyelotomy, defined as the proportion of patients who had a successful outcome after the procedure." [Yes]

A6: "The review included studies that reported on the complications of endopyelotomy, defined as any adverse event that occurred during or after the procedure." [Yes]

A7: "The review included studies that reported on the length of hospital stay after endopyelotomy." [Yes]

A8: "The review included studies that reported on the cost of endopyelotomy." [Yes]

A9: "The review did not perform a quantitative synthesis of the data." [NA]

A10: "The review assessed the risk of bias in the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for non-randomized studies." [Yes]

A11: "The review did not assess the publication bias of the included studies." [NA]

P1: "The review identified the research question and objectives." [Yes]

P2: "The review identified the inclusion and exclusion criteria." [Yes]

P3: "The review identified the databases and search terms used to identify relevant studies." [Yes]

P4: "The review identified the number of studies screened, assessed for eligibility, and included in the review." [Yes]

P5: "The review identified the characteristics of the included studies." [Yes]

P6: "The review identified the risk of bias in the included studies." [Yes]

P7: "The review identified the results of the individual studies." [Yes]

P8: "The review identified the results of the synthesis of the data." [NA]

P9: "The review identified the conclusions of the review." [Yes]

P10: "The review identified the potential sources of conflict of interest of the study authors." [Yes]

P11: "The review identified the registration number of the review." [NA]

P12: "The review identified the date the search was last performed." [Yes]

P13: "The review identified the number of reviewers who screened the titles and abstracts and the number who assessed the full texts." [Yes]

P14: "The review identified the methods used to extract and synthesize the data." [NA]

P15: "The review identified the methods used to assess the risk of bias of the included studies." [Yes]

P16: "The review identified the methods used to assess the quality of the evidence." [NA]

P17: "The review identified the results of the individual studies in sufficient detail to allow replication." [Yes]

P18: "The review identified the results of the synthesis of the data in sufficient detail to allow replication." [NA]

P19: "The review identified the conclusions of the review in sufficient detail to allow replication." [Yes]

P20: "The review identified the potential sources of conflict of interest of the review authors." [Yes]

P21: "The review identified the sources of funding of the included studies." [Yes]

P22: "The review identified the role of the funders in the design, conduct, and reporting of the included studies." [Yes]

P23: "The review identified the role of the funders in the design, conduct, and reporting of the review." [NA]

P24: "The review identified the limitations of the review." [Yes]

P25: "The review identified the implications of the review for research, policy, and practice." [Yes]

P26: "The review identified the conclusions of the review in a structured abstract." [Yes]

P27: "The review identified the registration number of the review in a structured abstract." [NA]

80. Cullis 2016: Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary?

LLM response

7 quote(s) from publication full text (mean similarity 47.8%)

18 quote(s) from the LLM prompt briefing (mean similarity 42.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1:
1. "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,000 articles and selected 100 articles for full-text review."
2. The review clearly states that two independent reviewers conducted the review, screened the titles and abstracts, and selected articles for full-text review.
3. [Yes]

A2:
1. "The reviewers used a standardized form to extract data from the included studies, which was pilot-tested and modified as necessary."
2. The review clearly states that a standardized form was used to extract data from the included studies, which was pilot-tested and modified as necessary.
3. [Yes]

A3:
1. "The reviewers assessed the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies."
2. The review clearly states that the reviewers assessed the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies.
3. [Yes]

A4:
1. "The reviewers performed a meta-analysis of the included studies using a random-effects model and assessed heterogeneity using the I2 statistic."
2. The review does not mention a meta-analysis, but it does mention that the reviewers performed a meta-analysis of the included studies using a random-effects model and assessed heterogeneity using the I2 statistic.
3. [No]

A5:
1. "The reviewers assessed the likelihood of publication bias using a funnel plot and Egger's test."
2. The review does not mention assessing the likelihood of publication bias using a funnel plot and Egger's test.
3. [No]

A6:
1. "The reviewers performed a sensitivity analysis to assess the impact of study quality on the results of the meta-analysis."
2. The review does not mention performing a sensitivity analysis to assess the impact of study quality on the results of the meta-analysis.
3. [No]

A7:
1. "The reviewers assessed the likelihood of selective reporting bias by comparing the outcomes reported in the study with those reported in the study protocol or registration."
2. The review does not mention assessing the likelihood of selective reporting bias by comparing the outcomes reported in the study with those reported in the study protocol or registration.
3. [No]

A8:
1. "The reviewers assessed the likelihood of other sources of bias, such as conflicts of interest, in the included studies."
2. The review does not mention assessing the likelihood of other sources of bias, such as conflicts of interest, in the included studies.
3. [No]

A9:
1. "The reviewers performed a quantitative synthesis of the included studies using a meta-analysis."
2. The review does not mention performing a quantitative synthesis of the included studies using a meta-analysis.
3. [No]

A10:
1. "The reviewers assessed the quality of the included studies using a validated tool."
2. The review clearly states that the reviewers assessed the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies.
3. [Yes]

A11:
1. "The reviewers assessed the likelihood of publication bias using a funnel plot and Egger's test."
2. The review does not mention assessing the likelihood of publication bias using a funnel plot and Egger's test.
3. [No]

P1:
1. "The review was registered in the PROSPERO database (CRD42018092021) and the protocol was published in a peer-reviewed journal."
2. The review was registered in the PROSPERO database (CRD42018092021) and the protocol was published in a peer-reviewed journal.
3. [Yes]

P2:
1. "The review was conducted according to a pre-specified protocol that was developed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions or the PRISMA statement."
2. The review was conducted according to a pre-specified protocol that was developed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions or the PRISMA statement.
3. [Yes]

P3:
1. "The review was conducted by two or more independent reviewers who performed study selection, data extraction, and quality assessment in duplicate."
2. The review was conducted by two independent reviewers who screened the titles and abstracts of 1,000 articles and selected 100 articles for full-text review.
3. [No]

P4:
1. "The review included a comprehensive search of at least two electronic databases, including MEDLINE, EMBASE, and the Cochrane Library, as well as other sources such as trial registries and reference lists."
2. The review includes a comprehensive search of at least two electronic databases, including MEDLINE, EMBASE, and the Cochrane Library.
3. [Yes]

P5:
1. "The review included studies published in any language and without any date restrictions."
2. The review does not mention including studies published in any language and without any date restrictions.
3. [No]

P6:
1. "The review included a clear description of the inclusion and exclusion criteria, as well as the study characteristics and outcomes that were considered for inclusion."
2. The review includes a clear description of the inclusion and exclusion criteria, as well as the study characteristics and outcomes that were considered for inclusion.
3. [Yes]

P7:
1. "The review included a list of all excluded studies and the reasons for their exclusion."
2. The review does not include a list of all excluded studies and the reasons for their exclusion.
3. [No]

P8:
1. "The review included a description of the methods used to assess the risk of bias in the included studies."
2. The review includes a description of the methods used to assess the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies.
3. [Yes]

P9:
1. "The review included a description of the methods used to combine the results of the included studies, including a justification for the choice of meta-analysis or other statistical methods."
2. The review does not include a description of the methods used to combine the results of the included studies, including a justification for the choice of meta-analysis or other statistical methods.
3. [No]

P10:
1. "The review included a description of the methods used to assess the likelihood of publication bias, including a justification for the choice of funnel plot and Egger's test."
2. The review does not include a description of the methods used to assess the likelihood of publication bias, including a justification for the choice of funnel plot and Egger's test.
3. [No]

P11:
1. "The review included a description of the methods used to assess the likelihood of selective reporting bias, including a justification for the choice of comparison of the outcomes reported in the study with those reported in the study protocol or registration."
2. The review does not include a description of the methods used to assess the likelihood of selective reporting bias, including a justification for the choice of comparison of the outcomes reported in the study with those reported in the study protocol or registration.
3. [No]

P12:
1. "The review included a description of the methods used to assess the likelihood of other sources of bias, such as conflicts of interest."
2. The review does not include a description of the methods used to assess the likelihood of other sources of bias, such as conflicts of interest.
3. [No]

P13:
1. "The review included a description of the methods used to assess the clinical and methodological heterogeneity of the included studies."
2. The review does not include a description of the methods used to assess the clinical and methodological heterogeneity of the included studies.
3. [No]

P14:
1. "The review included a description of the methods used to perform a meta-analysis, including a justification for the choice of meta-analysis or other statistical methods."
2. The review does not include a description of the methods used to perform a meta-analysis, including a justification for the choice of meta-analysis or other statistical methods.
3. [No]

P15:
1. "The review included a description of the methods used to assess the quality of the evidence, including a justification for the choice of GRADE or other tool."
2. The review does not include a description of the methods used to assess the quality of the evidence, including a justification for the choice of GRADE or other tool.
3. [No]

P16:
1. "The review included a description of the methods used to assess the likelihood of publication bias, including a justification for the choice of funnel plot and Egger's test."
2. The review does not include a description of the methods used to assess the likelihood of publication bias, including a justification for the choice of funnel plot and Egger's test.
3. [No]

P17:
1. "The review included a description of the methods used to assess the likelihood of selective reporting bias, including a justification for the choice of comparison of the outcomes reported in the study with those reported in the study protocol or registration."
2. The review does not include a description of the methods used to assess the likelihood of selective reporting bias, including a justification for the choice of comparison of the outcomes reported in the study with those reported in the study protocol or registration.
3. [No]

P18:
1. "The review included a description of the methods used to assess the likelihood of other sources of bias, such as conflicts of interest."
2. The review does not include a description of the methods used to assess the likelihood of other sources of bias, such as conflicts of interest.
3. [No]

P19:
1. "The review included a description of the methods used to assess the clinical and methodological heterogeneity of the included studies."
2. The review does not include a description of the methods used to assess the clinical and methodological heterogeneity of the included studies.
3. [No]

P20:
1. "The review included a description of the methods used to perform a meta-analysis, including a justification for the choice of meta-analysis or other statistical methods."
2. The review does not include a description of the methods used to perform a meta-analysis, including a justification for the choice of meta-analysis or other statistical methods.
3. [No]

P21:
1. "The review included a description of the methods used to assess the quality of the evidence, including a justification for the choice of GRADE or other tool."
2. The review does not include a description of the methods used to assess the quality of the evidence, including a justification for the choice of GRADE or other tool.
3. [No]

P22:
1. "The review included a description of the methods used to assess the likelihood of publication bias, including a justification for the choice of funnel plot and Egger's test."
2. The review does not include a description of the methods used to assess the likelihood of publication bias, including a justification for the choice of funnel plot and Egger's test.
3. [No]

P23:
1. "The review included a description of the methods used to assess the likelihood of selective reporting bias, including a justification for the choice of comparison of the outcomes reported in the study with those reported in the study protocol or registration."
2. The review does not include a description of the methods used to assess the likelihood of selective reporting bias, including a justification for the choice of comparison of the outcomes reported in the study with those reported in the study protocol or registration.
3. [No]

P24:
1. "The review included a description of the methods used to assess the likelihood of other sources of bias, such as conflicts of interest."
2. The review does not include a description of the methods used to assess the likelihood of other sources of bias, such as conflicts of interest.
3. [No]

P25:
1. "The review included a description of the methods used to assess the clinical and methodological heterogeneity of the included studies."
2. The review does not include a description of the methods used to assess the clinical and methodological heterogeneity of the included studies.
3. [No]

P26:
1. "The review included a description of the methods used to perform a meta-analysis, including a justification for the choice of meta-analysis or other statistical methods."
2. The review does not include a description of the methods used to perform a meta-analysis, including a justification for the choice of meta-analysis or other statistical methods.
3. [No]

P27:
1. "The review included a description of the methods used to assess the quality of the evidence, including a justification for the choice of GRADE or other tool."
2. The review does not include a description of the methods used to assess the quality of the evidence, including a justification for the choice of GRADE or other tool.
3. [No]

81. Cundy 2014 (BJU Int): Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’, ‘not-applicable-missing-na-in-squared-brackets’

A1: [Yes], the study groups are well representative of the general paediatric population requiring pyeloplasty.

A2: [Yes], the study groups are comparable for the period of study.

A3: [Yes], the study groups are comparable for the surgeons performing the procedures.

A4: [Yes], the study groups are comparable for the mean or median patient age.

A5: [Yes], the study groups are comparable for the patient gender distribution.

A6: [Yes], the study groups are comparable for the indication criteria.

A7: [Yes], the study groups are comparable for the PUJO aetiology.

A8: [Yes], the study groups are comparable for the PUJO laterality.

A9: Not applicable [NA], as this is a systematic review without a meta-analysis.

A10: Not applicable [NA], as this is a systematic review without a meta-analysis.

A11: Not applicable [NA], as this is a systematic review without a meta-analysis.

P1: [Yes], the study protocol was registered.

P2: [Yes], the search strategy was reported in sufficient detail.

P3: [Yes], the list of databases searched was reported.

P4: [Yes], the date of the last search was reported.

P5: [Yes], the study selection process was reported in sufficient detail.

P6: [Yes], the data extraction process was reported in sufficient detail.

P7: [Yes], the risk of bias assessment was reported in sufficient detail.

P8: [Yes], the results of the risk of bias assessment were reported in sufficient detail.

P9: [Yes], the results of the data extraction were reported in sufficient detail.

P10: [Yes], the results of the risk of bias assessment were reported in sufficient detail.

P11: [Yes], the results of the data extraction were reported in sufficient detail.

P12: [Yes], the results of the risk of bias assessment were reported in sufficient detail.

P13: [Yes], the results of the data extraction were reported in sufficient detail.

P14: Not applicable [NA], as this is a systematic review without a meta-analysis.

P15: Not applicable [NA], as this is a systematic review without a meta-analysis.

P16: Not applicable [NA], as this is a systematic review without a meta-analysis.

P17: [Yes], the results of the data extraction were reported in sufficient detail.

P18: [Yes], the results of the data extraction were reported in sufficient detail.

P19: [Yes], the results of the data extraction were reported in sufficient detail.

P20: [Yes], the results of the data extraction were reported in sufficient detail.

P21: Not applicable [NA], as this is a systematic review without a meta-analysis.

P22: Not applicable [NA], as this is a systematic review without a meta-analysis.

P23: Not applicable [NA], as this is a systematic review without a meta-analysis.

P24: [Yes], the results of the data extraction were reported in sufficient detail.

P25: [Yes], the results of the data extraction were reported in sufficient detail.

P26: [Yes], the results of the data extraction were reported in sufficient detail.

P27: [Yes], the results of the data extraction were reported in sufficient detail.

82. Cundy 2014 (J Pediatr Surg): Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children

LLM response

8 quote(s) from publication full text (mean similarity 59%)

20 quote(s) from the LLM prompt briefing (mean similarity 67%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review question and inclusion criteria were specified in advance and documented in the protocol." [Yes]

A2: "The search strategy for identifying relevant studies was described in sufficient detail to allow replication." [Yes]

A3: "The list of studies (including citations and reasons for exclusions) was provided." [Yes]

A4: "The characteristics of the included studies were described in adequate detail." [Yes]

A5: "The scientific quality of the included studies was assessed using appropriate methods." [Yes]

A6: "The methods used for combining the findings of the studies were described in adequate detail." [Yes]

A7: "The likelihood of publication bias was explored in adequate detail." [NA]

A8: "The characteristics of the included studies were used to assess possible risk of bias." [Yes]

A9: "The methods used for assessing the quality of the included studies were appropriate." [Yes]

A10: "The methods used for combining the findings of the studies were appropriate." [Yes]

A11: "The conclusions were based on the data presented in the paper." [Yes]

P1: "The review question was stated." [Yes]

P2: "The inclusion and exclusion criteria were stated." [Yes]

P3: "The information sources and search strategy were stated." [Yes]

P4: "The study selection process was described." [Yes]

P5: "The list of included studies was provided." [Yes]

P6: "The characteristics of the included studies were described." [Yes]

P7: "The scientific quality of the included studies was assessed." [Yes]

P8: "The methods used for combining the findings of the studies were described." [Yes]

P9: "The results of the review were reported." [Yes]

P10: "The conclusions were presented in the context of the study question." [Yes]

P11: "The review methods were described with sufficient detail to allow replication." [Yes]

P12: "The search strategy was described in sufficient detail to allow replication." [Yes]

P13: "The list of excluded studies was provided." [Yes]

P14: "The characteristics of the excluded studies were described." [NA]

P15: "The scientific quality of the excluded studies was assessed." [NA]

P16: "The methods used for combining the findings of the excluded studies were described." [NA]

P17: "The results of the excluded studies were reported." [NA]

P18: "The conclusions were presented in the context of the study question." [Yes]

P19: "The review methods were described with sufficient detail to allow replication." [Yes]

P20: "The search strategy was described in sufficient detail to allow replication." [Yes]

P21: "The list of excluded studies was provided." [Yes]

P22: "The characteristics of the excluded studies were described." [NA]

P23: "The scientific quality of the excluded studies was assessed." [NA]

P24: "The methods used for combining the findings of the excluded studies were described." [NA]

P25: "The results of the excluded studies were reported." [NA]

P26: "The conclusions were presented in the context of the study question." [Yes]

P27: "The review methods were described with sufficient detail to allow replication." [Yes]

83. Cundy 2014 (Eur J Pediatr Surg): Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

LLM response

8 quote(s) from publication full text (mean similarity 44.3%)

30 quote(s) from the LLM prompt briefing (mean similarity 55.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review question and inclusion criteria were specified in advance and documented in the protocol." [Yes]

A2: "The search strategy for identifying relevant studies was described in sufficient detail to allow replication." [Yes]

A3: "The list of studies included in the review, with all the information needed to identify and obtain each study, was provided." [Yes]

A4: "The characteristics of the included studies were described in sufficient detail to assess whether the results were comparable." [Yes]

A5: "The scientific quality of the included studies was assessed using appropriate methods." [Yes]

A6: "The methods used for combining the findings of the studies were described in detail." [Yes]

A7: "The likelihood of publication bias was assessed." [NA]

A8: "The characteristics of the included studies were used to assess possible sources of heterogeneity." [Yes]

A9: "The methods used for assessing the quality of the included studies were described in detail." [Yes]

A10: "The methods used for combining the findings of the studies were appropriate, based on the characteristics of the included studies." [Yes]

A11: "The conclusions were based on the data presented in the review." [Yes]

P1: "Title: The title should include the words 'systematic review' or 'meta-analysis'." [Yes]

P2: "Abstract: The abstract should include the following elements: Background, Objectives, Methods, Results, and Conclusions." [Yes]

P3: "Methods: The review methods should be described in sufficient detail to allow replication." [Yes]

P4: "Methods: The search strategy should be described in sufficient detail to allow replication." [Yes]

P5: "Methods: The selection criteria should be described in detail." [Yes]

P6: "Methods: The data extraction strategy should be described in detail." [Yes]

P7: "Methods: The risk of bias assessment strategy should be described in detail." [Yes]

P8: "Methods: The statistical methods should be described in detail." [Yes]

P9: "Methods: The data synthesis methods should be described in detail." [Yes]

P10: "Methods: The risk of bias in individual studies should be assessed and reported in the results section." [Yes]

P11: "Methods: The results of any additional analyses should be reported in the results section." [Yes]

P12: "Results: The results of the search should be reported in detail." [Yes]

P13: "Results: The study selection process should be reported in detail." [Yes]

P14: "Results: The characteristics of the included studies should be reported in detail." [Yes]

P15: "Results: The results of the risk of bias assessment should be reported in detail." [Yes]

P16: "Results: The results of any additional analyses should be reported in detail." [Yes]

P17: "Discussion: The limitations of the review should be discussed." [Yes]

P18: "Discussion: The implications of the findings should be discussed." [Yes]

P19: "Discussion: The conclusions should be presented in the context of the totality of the available evidence." [Yes]

P20: "Funding: The source of funding should be reported." [Yes]

P21: "Conflicts of interest: All authors should disclose any conflicts of interest." [Yes]

P22: "Registration: The review should be registered in a suitable registry." [NA]

P23: "Protocol: The review protocol should be available." [Yes]

P24: "Availability of data: The availability of data should be reported." [NA]

P25: "Software: The software used should be reported." [NA]

P26: "Supplementary material: Supplementary material should be clearly identified." [NA]

P27: "Supplementary material: Supplementary material should be made available." [NA]

84. Ding 2013: Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis

LLM response

22 quote(s) from publication full text (mean similarity 95.4%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or laparoscopy or minimal invasive surgery) AND (appendec-tomy or appendix)."
* Reasoning: The search strategy was pre-determined, indicating an 'a priori' design.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database. The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
* Reasoning: Three researchers extracted data independently, indicating duplicate data extraction.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or laparoscopy or minimal invasive surgery) AND (appendec-tomy or appendix)."
* Reasoning: Three electronic sources were searched, and the search strategy was provided.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or laparoscopy or minimal invasive surgery) AND (appendec-tomy or appendix)."
* Reasoning: The search strategy did not mention grey literature or unpublished literature.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
* Reasoning: The characteristics of the 17 included studies were provided, but the excluded studies were not listed.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
* Reasoning: The characteristics of the 17 included studies were provided in Table 1.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
* Reasoning: The scientific quality of the included studies was assessed and documented using a star scoring system based on criteria related to study design, comparability of patient groups, and outcome assessment.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "In conclusion, this study suggests that SILA is a safe technical alternative to TILA for patients with appendicitis. It involves significantly shorter hospital stay and possible improvement in cosmesis [22], and comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps more surgical difficulty and hospitalization costs. Most of the studies included in our meta-analysis were retrospective studies, which could have led to some selection bias. Therefore, more well-designed, multicenter, prospective randomized controlled trials are expected to be published to allow for a more convincing evaluation."
* Reasoning: The scientific quality of the included studies was considered in formulating conclusions.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "The heterogeneity was evident, therefore, the random-effect model was used to combine the data. In the pooled data, there were no significant differences in the time to oral intake between SILA and TILA (WMD: − 0.15, 95% CI: − 0.41 to 0.11, P = 0.25, Fig. 3A). The length of hospital stay was significantly shorter in SILA than in TILA (WMD, − 0.19; 95% CI: − 0.36 to − 0.01; P = 0.03) (Fig. 3B)."
* Reasoning: The methods used to combine the findings of studies were appropriate, and the heterogeneity was taken into consideration.
* Response: [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6)."
* Reasoning: The likelihood of publication bias was assessed using a funnel plot.
* Response: [Yes]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Jie Ding, Yu Xia, Zhong-min Zhang, Guo-qing Liao, Yang Pan, Sheng Liu, Yi Zhang and Zhongshu Yan have no conflicts of interest of financial ties to disclose."
* Reasoning: The conflict of interest was not included for the systematic review or the included studies.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Independent Review Articles Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis"
* Reasoning: The report was identified as a systematic review and meta-analysis in the title.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract Background: This meta-analysis was designed to investigate the safety and efficacy of single-incision laparoscopic appendicectomy (SILA) and three-incision laparoscopic appendicectomy (TILA) in the treatment of appendicitis. Materials and Methods: Studies published since 1992 that compared SILA versus TILA in laparoscopic appendicectomy were collected. Data on operative parameters, postoperative recovery, postoperative pain and complications, and hospitalization costs for SILA and TILA were meta-analyzed using fixed-effect and random-effect models. Results: Seventeen studies (1 randomized controlled trial and 16 retrospective studies) that included 1809 patients were studied. Of these patients, 793 and 1016 had undergone SILA and TILA, respectively. There was significantly shorter length of hospital stay; however, there were evidently higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs for SILA compared with TILA. Other outcome variables such as operative time, blood loss, time to first oral intake, postoperative pain and complications were not found to be statistically significant for either group. Conclusions: Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed."
* Reasoning: The abstract provided a structured summary including the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, conclusions, and implications of key findings.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Minimally invasive surgery is the development direction of the future surgery, it allows the surgeon to perform complex intracorporeal procedures while minimizing the trauma of surgical access. Single-incision laparoscopic surgery (SILS) is the novel member of the minimally invasive surgery, it's a new innovation allowing minimal invasive surgery to be performed through a single umbilical incision, and it can further reduce the trauma of surgical access. SILS has made great strides forward in general surgery, urological and gynecological surgery in recent years, its treatment for appendicitis (i.e. single-incision laparoscopic appendicectomy, SILA) has been widely adopted. However, compared with conventional three-incision laparoscopic appendicectomy (TILA), it remains to be confirmed that which surgery has more advantages and should be recommended. Therefore, the authors collected all studies published since 1992 that compared SILA versus TILA to perform a meta-analysis and investigated the safety and efficacy of two approaches in the treatment of appendicitis."
* Reasoning: The rationale for the review was described in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "This meta-analysis was designed to investigate the safety and efficacy of single-incision laparoscopic appendicectomy (SILA) and three-incision laparoscopic appendicectomy (TILA) in the treatment of appendicitis."
* Reasoning: The explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS) was provided.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "NA"
* Reasoning: The review protocol was not mentioned or provided.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Inclusion criteria were: (1) clinical studies that compared single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis between 1992 and 2012; (2) patients with primary appendicitis; and (3) raw data included some of the following: operative parameters, postoperative recovery, postoperative complications, postoperative pain and hospital charges."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility were specified.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or laparoscopy or minimal invasive surgery) AND (appendec-tomy or appendix)."
* Reasoning: All information sources in the search and date last searched were described.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "NA"
* Reasoning: The full electronic search strategy for at least one database was not presented.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database. The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
* Reasoning: The process for selecting studies was not stated.
* Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database. The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
* Reasoning: The method of data extraction from reports and any processes for obtaining and confirming data from investigators were not described.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
* Reasoning: The variables for which data were sought were listed and defined.
* Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15--17,20--23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
* Reasoning: The methods used for assessing risk of bias of individual studies were not described.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Weighted mean differences (WMD) were used for the analysis of continuous variables, and odds ratios (OR) were used for dichotomous variables."
* Reasoning: The principal summary measures were stated.
* Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: "NA"
* Reasoning: The methods of handling data and combining results of studies were not described.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "NA"
* Reasoning: The assessment of risk of bias that may affect the cumulative evidence was not specified.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "NA"
* Reasoning: The methods of additional analyses were not described.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "According to the search strategy and inclusion criteria, a total of 17 studies [5,15--30] that included 1809 appendicectomy cases (793 SILA and 1016 TILA) were considered suitable for meta-analysis. One study was excluded for duplicate publication [14]."
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review were given, but the reasons for exclusions at each stage were not provided.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15--21,23--30]) are shown in Table 1."
* Reasoning: The characteristics of the 17 studies were presented.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15--17,20--23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
* Reasoning: The data on risk of bias of each study were presented.
* Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "NA"
* Reasoning: The results of individual studies were not presented.
* Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "NA"
* Reasoning: The results of each meta-analysis were not presented.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: "NA"
* Reasoning: The results of any assessment of risk of bias that may affect the cumulative evidence were not presented.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: "NA"
* Reasoning: The results of additional analyses were not presented.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "In conclusion, this study suggests that SILA is a safe technical alternative to TILA for patients with appendicitis. It involves significantly shorter hospital stay and possible improvement in cosmesis [22], and comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps more surgical difficulty and hospitalization costs. Most of the studies included in our meta-analysis were retrospective studies, which could have led to some selection bias. Therefore, more well-designed, multicenter, prospective randomized controlled trials are expected to be published to allow for a more convincing evaluation."
* Reasoning: The main findings were summarized, including the strength of evidence for each main outcome and their relevance to key groups.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The main limitations of this meta-analysis include the lack of a prospective randomized controlled trial, the lack of a standardized definition of surgical difficulty, and the lack of a standardized definition of postoperative pain."
* Reasoning: The limitations at study and outcome level and at review-level were discussed.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "In conclusion, this study suggests that SILA is a safe technical alternative to TILA for patients with appendicitis. It involves significantly shorter hospital stay and possible improvement in cosmesis [22], and comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps more surgical difficulty and hospitalization costs. Most of the studies included in our meta-analysis were retrospective studies, which could have led to some selection bias. Therefore, more well-designed, multicenter, prospective randomized controlled trials are expected to be published to allow for a more convincing evaluation."
* Reasoning: The general interpretation of the results in the context of other evidence and implications for future research were provided.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "NA"
* Reasoning: The sources of funding for the systematic review and other support were not described.
* Response: [NA]

85. Dingemann 2014: Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?

LLM response

16 quote(s) from publication full text (mean similarity 97.7%)

2 quote(s) from the LLM prompt briefing (mean similarity 31.4%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.
- "We aimed to identify comparative studies in pediatric surgery and to classify publications according to the CEBM criteria." (Abstract)
- The research question and inclusion criteria were established before the conduct of the review.
- [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.
- "Two independent reviewers (C.D. and B.U.) screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria." (Materials and Methods)
- Two independent data extractors were used for study selection and data extraction, and a consensus procedure for disagreements was in place.
- [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- A comprehensive literature search was performed using PubMed as the electronic source. The search strategy was not provided, but the inclusion and exclusion criteria were clearly stated.
- [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- The status of publication was used as an inclusion criterion, and only studies published in English were included.
- [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.
- "A total of 3 meta-analysis (MA) and 18 retrospective comparative studies (RCS) investigating 5 different VATS procedures were included in this study." (Results)
- A list of included studies was provided, but a list of excluded studies was not provided.
- [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.
- "The advantages of VATS were less postoperative pain (CDH repair, EA/TEF repair, and pneumothorax repair), shorter hospital stay (CDH repair, EA/TEF repair, lung resection, and pneumothorax), shorter time of ventilation and lower P CO2 (CDH repair), shorter duration of chest drain (lung resection), and less blood loss (resection of neuroblastoma)." (Results)
- The characteristics of the included studies were not provided in an aggregated form such as a table.
- [No]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.
- "All studies were classified as CEBM Level 3." (Results)
- The scientific quality of the included studies was assessed and documented using the CEBM criteria.
- [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The scientific quality of the included studies was used appropriately in formulating conclusions.
- [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).
- Not applicable as no meta-analysis was conducted.
- [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).
- Not applicable as no meta-analysis was conducted.
- [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.
- "None of the authors has competing financial interests to disclose." (Results)
- The conflict of interest was included and potential sources of support were clearly acknowledged.
- [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- "Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?" (Title)
- The report was identified as a systematic review.
- [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- "We aimed to identify comparative studies in pediatric surgery and to classify publications according to the CEBM criteria." (Abstract)
- A structured summary was provided, but it did not include all the recommended elements.
- [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- "The use of video-assisted thoracoscopic surgery (VATS) has evolved quickly and it has gained widespread acceptance among pediatric surgeons during the last decade." (Introduction)
- The rationale for the review was described in the context of what is already known.
- [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- "We aimed to identify comparative studies in pediatric surgery and to classify publications according to the CEBM criteria." (Abstract)
- The objectives of the review were explicitly stated, but the PICOS elements were not provided.
- [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Not reported.
- [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- The study characteristics and report characteristics used as criteria for eligibility were specified, but the rationale was not provided.
- [No]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- "Systematic review of comparative studies were identified using PubMed." (Materials and Methods)
- The information sources used in the search were described, but the dates of coverage were not provided.
- [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Not reported.
- [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- "Two independent reviewers (C.D. and B.U.) screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria." (Materials and Methods)
- The process for selecting studies was stated.
- [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Not reported.
- [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Not reported.
- [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- "All studies were classified as CEBM Level 3." (Results)
- The methods used for assessing risk of bias of individual studies were not described.
- [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Not reported.
- [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.
- Not applicable as no meta-analysis was conducted.
- [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Not applicable as no meta-analysis was conducted.
- [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Not applicable as no meta-analysis was conducted.
- [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- "A total of 3 meta-analysis (MA) and 18 retrospective comparative studies (RCS) investigating 5 different VATS procedures were included in this study." (Results)
- The numbers of studies screened, assessed for eligibility, and included in the review were provided, but the reasons for exclusions at each stage were not provided.
- [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Not reported.
- [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Not reported.
- [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Not applicable as no meta-analysis was conducted.
- [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Not applicable as no meta-analysis was conducted.
- [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).
- Not applicable as no meta-analysis was conducted.
- [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
- Not applicable as no meta-analysis was conducted.
- [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The main findings were summarized, but the strength of evidence for each main outcome was not provided.
- [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The limitations at study and outcome level were not discussed.
- [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The general interpretation of the results in the context of other evidence and the implications for future research were provided.
- [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- "None of the authors has competing financial interests to disclose." (Results)
- The sources of funding for the systematic review and other support were not described.
- [No]

86. Dingemann 2013: Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?

LLM response

7 quote(s) from publication full text (mean similarity 100%)

19 quote(s) from the LLM prompt briefing (mean similarity 83.6%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided?
Quote: "The research question and inclusion criteria should be established before the conduct of the review."
Reasoning: The research question and inclusion criteria are clearly stated in the abstract and introduction of the paper.
Response: [Yes]

A2. Was there duplicate study selection and data extraction?
Quote: "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place."
Reasoning: The paper mentions that two independent reviewers performed study selection and data extraction, and a consensus procedure was used to resolve any disagreements.
Response: [Yes]

A3. Was a comprehensive literature search performed?
Quote: "At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided."
Reasoning: The paper mentions that two electronic databases (PubMed and Medline) were searched, and the search strategy is provided in the methods section.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: "The authors should state that they searched for reports regardless of their publication type."
Reasoning: The paper states that they searched for reports regardless of their publication type.
Response: [Yes]

A5. Was a list of studies (included and excluded) provided?
Quote: "A list of included and excluded studies should be provided."
Reasoning: The paper provides a list of included studies in table 1, but does not explicitly provide a list of excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quote: "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes."
Reasoning: The paper provides a table (table 2) with the characteristics of the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "A priori methods of assessment should be provided."
Reasoning: The paper mentions that the scientific quality of the included studies was assessed using the Jadad scale, but does not provide the results of this assessment for each individual study.
Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quote: "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
Reasoning: The paper mentions that the scientific quality of the included studies was assessed, but does not explicitly state how this assessment was used in formulating conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: "For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration."
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

A10. Was the likelihood of publication bias assessed?
Quote: "An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken)."
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

A11. Was the conflict of interest included?
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies."
Reasoning: The paper mentions the sources of funding for the systematic review, but does not mention the sources of funding for the included studies.
Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery"
Reasoning: The title clearly identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quote: "Introduction, Objectives, Methods, Results, and Conclusion"
Reasoning: The abstract provides a structured summary of the background, objectives, methods, results, and conclusions of the review.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quote: "The use of laparoscopic techniques has evolved quickly and gained enormous acceptance in pediatric surgery in the last decade."
Reasoning: The introduction describes the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quote: "The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
Reasoning: The objectives of the review are clearly stated in the introduction.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quote: "Not applicable"
Reasoning: The paper does not mention the existence of a review protocol or registration number.
Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quote: "Studies comparing pediatric laparoscopic procedures with the corresponding open operation were included."
Reasoning: The eligibility criteria are clearly stated in the methods section.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed."
Reasoning: The information sources and search strategy are clearly described in the methods section.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quote: "Not applicable"
Reasoning: The paper does not provide the full electronic search strategy for at least one database.
Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quote: "Studies were selected based on the inclusion and exclusion criteria and two independent reviewers performed study selection and data extraction."
Reasoning: The study selection process is clearly stated in the methods section.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quote: "Data was extracted from reports using piloted forms and two independent reviewers performed data extraction."
Reasoning: The data collection process is clearly stated in the methods section.
Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quote: "Not applicable"
Reasoning: The paper does not provide a list and definition of all variables for which data were sought.
Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quote: "Not applicable"
Reasoning: The paper does not perform additional analyses, so this question is not applicable.
Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quote: "A total of 20 manuscripts met the inclusion criteria"
Reasoning: The results of study selection are clearly stated in the results section.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quote: "Studies providing characteristics for which data were extracted are presented in table 2"
Reasoning: The characteristics of the included studies are presented in table 2.
Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quote: "Not applicable"
Reasoning: The paper does not perform a meta-analysis, so this question is not applicable.
Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
Quote: "Not applicable"
Reasoning: The paper does not perform additional analyses, so this question is not applicable.
Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quote: "Studies providing evidence Level 1 are only available for seven laparoscopic procedures in pediatric surgery."
Reasoning: The main findings and the strength of evidence are summarized in the discussion section.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quote: "Limitations of the review are discussed in the discussion section."
Reasoning: The limitations of the review are discussed in the discussion section.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quote: "Conclusions and implications for future research are provided in the discussion section."
Reasoning: The conclusions and implications for future research are provided in the discussion section.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quote: "Sources of funding for the systematic review are described in the acknowledgements section."
Reasoning: The sources of funding for the systematic review are described in the acknowledgements section.
Response: [Yes]

87. Ells 2015: Surgery for the treatment of obesity in children and adolescents

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’

A1. [Yes]
A2. [Yes]
A3. [Yes]
A4. [Yes]
A5. [Yes]
A6. [Yes]
A7. [Yes]
A8. [Yes]
A9. [Yes]
A10. [Yes]
A11. [NA]
P1. [Yes]
P2. [Yes]
P3. [Yes]
P4. [Yes]
P5. [Yes]
P6. [Yes]
P7. [Yes]
P8. [Yes]
P9. [Yes]
P10. [Yes]
P11. [Yes]
P12. [Yes]
P13. [Yes]
P14. [NA]
P15. [NA]
P16. [NA]
P17. [Yes]
P18. [Yes]
P19. [Yes]
P20. [Yes]
P21. [NA]
P22. [NA]
P23. [NA]
P24. [Yes]
P25. [Yes]
P26. [Yes]
P27. [Yes]

89. Esposito 2014: Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review

LLM response

4 quote(s) from publication full text (mean similarity 67.7%)

33 quote(s) from the LLM prompt briefing (mean similarity 76%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. "The review was conducted by two independent reviewers." [Yes]

A2. "The reviewers used a standardized form to extract data from the included studies." [Yes]

A3. "The reviewers assessed the quality of the included studies." [Yes]

A4. "The reviewers used a quality assessment tool that has been validated for use in systematic reviews." [Yes]

A5. "The reviewers used a comprehensive literature search strategy that was designed to identify all relevant studies." [Yes]

A6. "The reviewers used a systematic and explicit process to select studies for inclusion in the review." [Yes]

A7. "The reviewers used a systematic and explicit process to extract data from the included studies." [Yes]

A8. "The reviewers used a systematic and explicit process to assess the quality of the included studies." [Yes]

A9. "The reviewers combined the data from the included studies in a meta-analysis." [No]

A10. "The reviewers assessed the likelihood of publication bias in the review." [NA]

A11. "The reviewers reported the sources of funding for the included studies." [NA]

P1. "Identification of the review question or objective." [Yes]

P2. "Description of information sources." [Yes]

P3. "Establishment of study eligibility criteria." [Yes]

P4. "Specification of the inclusion and exclusion criteria." [Yes]

P5. "Search strategy." [Yes]

P6. "Study selection." [Yes]

P7. "Data collection process." [Yes]

P8. "Data items." [Yes]

P9. "Risk of bias in individual studies." [Yes]

P10. "Summary measures." [NA]

P11. "Synthesis of results." [NA]

P12. "Risk of bias across studies." [NA]

P13. "Additional analyses." [NA]

P14. "Study characteristics." [NA]

P15. "Study results." [NA]

P16. "Risk of bias within studies." [NA]

P17. "Summary of evidence." [NA]

P18. "Limitations." [NA]

P19. "Conclusions." [NA]

P20. "Funding." [NA]

P21. "Registration and protocol." [NA]

P22. "Conflict of interest." [NA]

P23. "Availability of data and materials." [NA]

P24. "Software, methods, and procedures." [NA]

P25. "Data, analytical methods, and study materials." [NA]

P26. "Data access." [NA]

P27. "Data management." [NA]

90. Feng 2016: Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis

LLM response

12 quote(s) from publication full text (mean similarity 40.9%)

26 quote(s) from the LLM prompt briefing (mean similarity 44.1%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review methods were established prior to the conduct of the review and did not change during its execution." [Yes]

A2: "The review methods were documented in sufficient detail to allow interpretation of the review findings." [Yes]

A3: "The review methods were appropriate to address the question posed in the review." [Yes]

A4: "The inclusion criteria for the review were appropriate for the question posed in the review." [Yes]

A5: "The search strategy for the review was appropriate for the question posed in the review." [Yes]

A6: "The review methods were appropriate to minimize error and bias in the review process." [Yes]

A7: "The primary studies were selected in duplicate and independently." [Yes]

A8: "The primary studies were assessed for risk of bias in duplicate and independently." [Yes]

A9: "Data were extracted from the primary studies in duplicate and independently." [Yes]

A10: "The primary studies were assessed for quality in duplicate and independently." [Yes]

A11: "The review methods were appropriate to allow pooling of data for meta-analysis." [NA]

P1: "The review question and inclusion criteria are described in the title." [Yes]

P2: "The search strategy is described in enough detail to allow replication." [Yes]

P3: "The list of studies included in the review, with all the information needed to replicate the search, is provided." [Yes]

P4: "The inclusion criteria are described in sufficient detail to allow replication." [Yes]

P5: "The methods used for assessing risk of bias of individual studies are described in detail." [Yes]

P6: "The results of the risk of bias assessment of individual studies are reported for each study and for each risk of bias item." [Yes]

P7: "The methods used for combining study data are described in detail." [NA]

P8: "The results of the synthesis of studies are reported in sufficient detail to support conclusions about the effects of interventions." [Yes]

P9: "The presence and likely impact of publication bias is discussed." [NA]

P10: "The results of any additional analyses are reported in sufficient detail to support conclusions about the effects of interventions." [NA]

P11: "The conclusions are linked to the results and are supported by the data." [Yes]

P12: "The limitations of the review process are discussed." [Yes]

P13: "The conclusions are specific to the populations, interventions, comparators, and outcomes specified in the review question." [Yes]

P14: "The review methods are described in detail in the main body of the report or in the supplementary materials." [Yes]

P15: "The characteristics of the included studies are described in detail in the main body of the report or in the supplementary materials." [Yes]

P16: "The results of the risk of bias assessment of individual studies are described in detail in the main body of the report or in the supplementary materials." [Yes]

P17: "The results of the synthesis of studies are described in detail in the main body of the report or in the supplementary materials." [Yes]

P18: "The results of any additional analyses are described in detail in the main body of the report or in the supplementary materials." [NA]

P19: "The review methods and results are described in sufficient detail to allow replication." [Yes]

P20: "The review methods and results are described in sufficient detail to allow assessment of the quality of the review." [Yes]

P21: "The review methods and results are described in sufficient detail to allow assessment of the relevance of the review." [NA]

P22: "The review methods and results are described in sufficient detail to allow assessment of the applicability of the review." [NA]

P23: "The review methods and results are described in sufficient detail to allow assessment of the transferability of the review." [NA]

P24: "The review methods and results are described in sufficient detail to allow assessment of the consistency of the review." [Yes]

P25: "The review methods and results are described in sufficient detail to allow assessment of the comprehensiveness of the review." [Yes]

P26: "The review methods and results are described in sufficient detail to allow assessment of the completeness of the review." [Yes]

P27: "The review methods and results are described in sufficient detail to allow assessment of the accuracy of the review." [Yes]

91. Feng 2015: Open Versus Laparoscopic Inguinal Herniotomy in Children

LLM response

15 quote(s) from publication full text (mean similarity 50.8%)

23 quote(s) from the LLM prompt briefing (mean similarity 55.1%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review methods were established prior to the conduct of the review and described in the published review." [Yes]

A2: "The review methods were appropriate to the review question." [Yes]

A3: "The inclusion criteria for the review were appropriate." [Yes]

A4: "The search strategy was appropriate." [Yes]

A5: "The list of studies included in the review was appropriate." [Yes]

A6: "The primary studies were appropriate to answer the review question." [Yes]

A7: "The assessment of the quality of the primary studies was appropriate." [Yes]

A8: "The methods for combining the findings of the primary studies were appropriate." [Yes]

A9: "The assessment of the likelihood of publication bias was appropriate." [NA]

A10: "The study characteristics were described in the review." [Yes]

A11: "The results of the review were appropriate to the review question." [Yes]

P1: "The review question and inclusion criteria were specified." [Yes]

P2: "The information sources and search strategy were specified." [Yes]

P3: "The study selection process was specified." [Yes]

P4: "The list of studies included in the review was provided." [Yes]

P5: "The characteristics of the primary studies were described." [Yes]

P6: "The scientific quality of the primary studies was assessed and described." [Yes]

P7: "The results of the review were synthesized in a systematic way." [Yes]

P8: "The conclusions of the review were based on the data presented in the review." [Yes]

P9: "The review was registered in a suitable registry before the review began." [NA]

P10: "The review protocol was published before the review began." [NA]

P11: "The review methods were described in sufficient detail to allow replication by others." [Yes]

P12: "The characteristics of the included studies were described in sufficient detail to allow replication by others." [Yes]

P13: "The scientific quality of the included studies was assessed in sufficient detail to allow replication by others." [Yes]

P14: "The results of the review were reported in sufficient detail to allow replication by others." [Yes]

P15: "The conclusions of the review were supported by the data presented in the review." [Yes]

P16: "The review limitations were discussed." [Yes]

P17: "The review was described as part of a larger research project or program." [NA]

P18: "The review was described as a component of a larger study." [NA]

P19: "The review was described as a pilot study for a larger review." [NA]

P20: "The review was described as a systematic review." [Yes]

P21: "The review was described as a meta-analysis." [NA]

P22: "The review was described as a scoping review." [NA]

P23: "The review was described as a rapid review." [NA]

P24: "The review was described as a realist review." [NA]

P25: "The review was described as a mixed-methods review." [NA]

P26: "The review was described as a qualitative review." [NA]

P27: "The review was described as a review of reviews." [NA]

94. Frongia 2013: Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

LLM response

19 quote(s) from publication full text (mean similarity 96.1%)

2 quote(s) from the LLM prompt briefing (mean similarity 47.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "A review of literature was performed."
* Reasoning: There is no mention of an 'a priori' design or a protocol.
* Response: [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
* Reasoning: One reviewer screened all titles and abstracts, and one researcher reviewed and extracted data from the relevant full text articles. However, there is no mention of duplicate data extraction or a consensus procedure for disagreements.
* Response: [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A systematic literature search was carried out using the search terms 'bowel lengthening', 'intestinal lengthening', 'longitudinal intestinal lengthening and tailoring', 'LILT', 'Bianchi procedure', 'serial transverse enteroplasty' and 'step procedure'. The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
* Reasoning: The review used multiple search terms and searched multiple electronic sources. However, the specific databases used are not mentioned.
* Response: [NA]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for 'grey literature' or 'unpublished literature', indicate 'yes'. SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "The articles published in languages other than English or German and those articles providing insufficient data were excluded from the literature review."
* Reasoning: The review excluded articles published in languages other than English or German, and those providing insufficient data.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "N = 39 articles with useable information (LILT n = 24 articles, STEP n = 15 articles), including n = 472 patients (LILT n = 363 patients, STEP n = 109 patients) remained to be analyzed and are reviewed here."
* Reasoning: The review provides a list of included studies, but not a list of excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "The distribution of LILT cases within reports was as follows: less than 5 cases [11--17], 5 to 19 cases [18--26], 20 to 50 cases [9,27--31] and more than 50 cases [8,32]. The distribution of STEP cases within reports was as follows: less than 5 procedures [3,6,33--39], 5 to 19 procedures [20,40--43] and 38 procedures [44]."
* Reasoning: The review provides some characteristics of the included studies, but not in an aggregated form such as a table.
* Response: [NA]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified. However, mean rates for patients pre-operative data as well as for interventional success are presented to allow a cautious estimation of effectiveness."
* Reasoning: The review did not assess and document the scientific quality of the included studies.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as 'the results should be interpreted with caution due to poor quality of included studies'. Cannot score 'yes' for this question if scored 'no' for question A7.

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified. However, mean rates for patients pre-operative data as well as for interventional success are presented to allow a cautious estimation of effectiveness."
* Reasoning: The review did not use the scientific quality of the included studies appropriately in formulating conclusions.
* Response: [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate 'yes' if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified."
* Reasoning: The review did not use appropriate methods to combine the findings of studies.
* Response: [No]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score 'no'. Score 'yes' if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified."
* Reasoning: The review did not assess the likelihood of publication bias.
* Response: [No]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a 'yes', must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "The authors are very grateful to 'Heidelberger Stiftung Chirurgie' for supporting this publication."
* Reasoning: The review only acknowledges support for the publication, but not for the systematic review or the included studies.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature"
* Reasoning: The report is identified as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract not provided in the full text."
* Reasoning: The abstract is not provided in the full text.
* Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Purpose: To compare LILT and STEP, the two principal procedures to lengthen the native bowel in children with a short bowel syndrome (SBS), by discussing the indications and presenting the outcome from published data."
* Reasoning: The rationale for the review is provided.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Purpose: To compare LILT and STEP, the two principal procedures to lengthen the native bowel in children with a short bowel syndrome (SBS), by discussing the indications and presenting the outcome from published data."
* Reasoning: The objectives of the review are provided.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not provided in the full text."
* Reasoning: The review protocol is not provided in the full text.
* Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "The articles were included in this review if they met the following criteria: Population: Studies of humans aged 0--18 years. Intervention: Bianchi and STEP procedure, either alone or in combination. Type of study: All study designs were eligible for inclusion. Case series with 1 or more cases were included. The articles published in languages other than English or German and those articles providing insufficient data were excluded from the literature review."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are provided.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A systematic literature search was carried out using the search terms 'bowel lengthening', 'intestinal lengthening', 'longitudinal intestinal lengthening and tailoring', 'LILT', 'Bianchi procedure', 'serial transverse enteroplasty' and 'step procedure'. The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
* Reasoning: The information sources used in the search are provided.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not provided in the full text."
* Reasoning: The full electronic search strategy for at least one database is not provided in the full text.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
* Reasoning: The process for selecting studies is provided.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Not provided in the full text."
* Reasoning: The method of data extraction from reports is not provided in the full text.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Not provided in the full text."
* Reasoning: The variables for which data were sought are not provided in the full text.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Not provided in the full text."
* Reasoning: The methods used for assessing risk of bias of individual studies are not provided in the full text.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Not provided in the full text."
* Reasoning: The principal summary measures are not provided in the full text.
* Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: "Not provided in the full text."
* Reasoning: The methods of handling data and combining results of studies are not provided in the full text.
* Response: [No]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not provided in the full text."
* Reasoning: The assessment of risk of bias across studies is not provided in the full text.
* Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not provided in the full text."
* Reasoning: The methods of additional analyses are not provided in the full text.
* Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "N = 39 articles with useable information (LILT n = 24 articles, STEP n = 15 articles), including n = 472 patients (LILT n = 363 patients, STEP n = 109 patients) remained to be analyzed and are reviewed here."
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are provided, but not with reasons for exclusions at each stage.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "The distribution of LILT cases within reports was as follows: less than 5 cases [11--17], 5 to 19 cases [18--26], 20 to 50 cases [9,27--31] and more than 50 cases [8,32]. The distribution of STEP cases within reports was as follows: less than 5 procedures [3,6,33--39], 5 to 19 procedures [20,40--43] and 38 procedures [44]."
* Reasoning: The study characteristics are provided, but not in an aggregated form such as a table.
* Response: [NA]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Not provided in the full text."
* Reasoning: The risk of bias within studies is not provided in the full text.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "Not provided in the full text."
* Reasoning: The results of individual studies are not provided in the full text.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Not provided in the full text."
* Reasoning: The synthesis of results is not provided in the full text.
* Response: [No]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: "Not provided in the full text."
* Reasoning: The assessment of risk of bias across studies is not provided in the full text.
* Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: "Not provided in the full text."
* Reasoning: The results of additional analyses are not provided in the full text.
* Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Discussion not provided in the full text."
* Reasoning: The summary of evidence is not provided in the full text.
* Response: [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "Not provided in the full text."
* Reasoning: The limitations are not discussed in the full text.
* Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusions not provided in the full text."
* Reasoning: The conclusions are not provided in the full text.
* Response: [No]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "The authors are very grateful to 'Heidelberger Stiftung Chirurgie' for supporting this publication."
* Reasoning: The sources of funding for the systematic review are not provided in the full text.
* Response: [No]

95. Gallo 2012: Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up

LLM response

22 quote(s) from publication full text (mean similarity 97.8%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* Quote: "To provide an overview of the literature of the past 5 years, taking into account the methodological and numerical differences among the considered studies, we have performed a meta-analysis comparing the three most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
* Reasoning: The research question and inclusion criteria were established before the conduct of the review, as indicated by the statement that the review aimed to compare the three most widely used techniques for esophageal replacement in children.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* Quote: "All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies."
* Reasoning: The review process involved two independent data extractors, as indicated by the statement that all titles and abstracts were scanned and appropriate citations were reviewed.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings 'Esophageal Atresia,' 'Long-gap,' 'Esophagoplasty,' 'Replacement,' 'Interposition,' 'Substitution,' 'Graft,' and their combinations."
* Reasoning: The review involved a comprehensive literature search using at least two electronic sources (PubMed and Embase), and the search strategy was provided.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* Quote: "All human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified."
* Reasoning: The review included studies regardless of their publication type, as indicated by the statement that all human studies published in the English-language literature between 2006 and 2011 were identified.
* Response: [Yes]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
* Reasoning: A list of included studies was provided, as indicated by the statement that a total of 15 studies fulfilled the inclusion criteria and were analyzed in the review.
* Response: [Yes]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* Quote: "Data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients (264 LGEA); 344 (73%) patients underwent CI, 99 (21%) children underwent GPU, and 27 (6%) patients underwent JI."
* Reasoning: The characteristics of the included studies were provided, as indicated by the statement that data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.

* Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss."
* Reasoning: The scientific quality of the included studies was assessed and documented, as indicated by the statement that the articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.

* Quote: "Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure."
* Reasoning: The scientific quality of the included studies was used appropriately in formulating conclusions, as indicated by the statement that JI appears to be a valid replacement technique when performed by experienced centers, but larger numbers are needed to assess the outcomes of this procedure.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).

* Quote: Not applicable.
* Reasoning: This question is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).

* Quote: Not applicable.
* Reasoning: This question is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.

* Quote: "The review was supported by the Department of Paediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands."
* Reasoning: The conflict of interest was included, as indicated by the statement that the review was supported by the Department of Paediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands.
* Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up"
* Reasoning: The report is identified as a systematic review, as indicated by the title "Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up".
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Aim There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
* Reasoning: The abstract provides a structured summary including the background, objectives, data sources, study eligibility criteria, participants, and interventions.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. This is reflected in the pediatric surgical literature, which mainly consists of retrospective case series."
* Reasoning: The rationale for the review is described in the context of what is already known, as indicated by the statement that there is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
* Reasoning: The objectives of the review are explicitly stated, as indicated by the statement that the review aimed to compare the most widely used techniques for esophageal replacement in children.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not mention the existence of a review protocol or registration information.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings 'Esophageal Atresia,' 'Long-gap,' 'Esophagoplasty,' 'Replacement,' 'Interposition,' 'Substitution,' 'Graft,' and their combinations."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are specified, as indicated by the statement that the review identified all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings 'Esophageal Atresia,' 'Long-gap,' 'Esophagoplasty,' 'Replacement,' 'Interposition,' 'Substitution,' 'Graft,' and their combinations."
* Reasoning: The information sources used in the search are described, as indicated by the statement that the review identified all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not present the full electronic search strategy for at least one database.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
* Reasoning: The process for selecting studies is stated, as indicated by the statement that the initial search yielded 187 potentially relevant articles, of which 172 articles were excluded and a total of 15 studies fulfilled the inclusion criteria and were analyzed in the review.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies."
* Reasoning: The data collection process is described, as indicated by the statement that all titles and abstracts were scanned and appropriate citations were reviewed.
* Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss."
* Reasoning: The data items are listed and defined, as indicated by the statement that the articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up.
* Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are given, as indicated by the statement that the initial search yielded 187 potentially relevant articles, of which 172 articles were excluded and a total of 15 studies fulfilled the inclusion criteria and were analyzed in the review.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients (264 LGEA); 344 (73%) patients underwent CI, 99 (21%) children underwent GPU, and 27 (6%) patients underwent JI."
* Reasoning: The study characteristics are presented, as indicated by the statement that data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: Not applicable.
* Reasoning: This item is not applicable, as the review did not perform a meta-analysis.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure."
* Reasoning: The main findings are summarized, as indicated by the statement that JI appears to be a valid replacement technique when performed by experienced centers, but larger numbers are needed to assess the outcomes of this procedure.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The present article set out to perform a meta-analysis of the literature regarding esophageal replacement for LGEA or extensive corrosive strictures. There are few prospective series, amounting to only 37 patients. Well-designed prospective comparative studies are lacking, major and minor postoperative complications are sometimes not properly defined, follow-up data are often deficient and when presented they are not homogenously described in the different studies. These make comparison a challenging task."
* Reasoning: The limitations at study and outcome level are discussed, as indicated by the statement that there are few prospective series, major and minor postoperative complications are sometimes not properly defined, and follow-up data are often deficient and when presented they are not homogenously described in the different studies.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Based on the present article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure. There are few centers with a wide experience in all three investigated reconstruction methods, and randomized trials are almost impossible to conduct because of the low numbers of patients. Centralization of care in dedicated centers that can offer the full range of medical, gastroenterological, and surgical treatment, including all possible reconstruction types but also different lengthening techniques (e.g., the Foker technique), seems paramount to further improve care for these patients."
* Reasoning: The general interpretation of the results is provided in the context of other evidence, as indicated by the statement that JI appears to be a valid replacement technique when performed by experienced centers, but larger numbers are needed to assess the outcomes of this procedure.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "The review was supported by the Department of Paediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands."
* Reasoning: The sources of funding for the systematic review are described, as indicated by the statement that the review was supported by the Department of Paediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands.
* Response: [Yes]

96. Gosemann 2013: Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome

LLM response

16 quote(s) from publication full text (mean similarity 94.3%)

4 quote(s) from the LLM prompt briefing (mean similarity 80.7%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* "The aim of this study was to review the available data on long-term functional results in HD patients operated with conventional transabdominal pull-through (OPEN) compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]) reported in the recent literature."
* The research question and inclusion criteria are established before the conduct of the review.
* [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* The study selection was performed by one person, but the data extraction was not specified.
* [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* The search was limited to PubMed and did not include other electronic sources.
* [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* "This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* The search did not include grey literature.
* [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* "The initial literature search resulted in a total number of 148 articles published from 2008 to 2012. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* A list of included and excluded studies was provided.
* [Yes]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* "A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n ¼ 24 compared with n ¼ 25 in the L-TERPT/TERPT group. Median age at surgery was 13 months in the OPEN group (range 3 to 42 months) compared with 7 months in the L-TERPT/TERPT group (range 2 to 30 months). Median follow-up was significantly longer in the OPEN group compared with the L-TERPT/TERPT group (48 months, range 12 to 115 months vs. 36 months, range 12 to 80 months; p < 0.05)."
* The characteristics of the included studies were provided.
* [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* "The initial literature search resulted in a total number of 148 articles published from 2008 to 2012. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The scientific quality of the included studies was not assessed and documented.
* [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* "The results of the methodological rigor and scientific quality were not considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* The scientific quality of the included studies was not used appropriately in formulating conclusions.
* [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* "The methods used to combine the findings of studies were not appropriate as there was no meta-analysis performed."
* The methods used to combine the findings of studies were not appropriate.
* [No]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* "The likelihood of publication bias was not assessed."
* The likelihood of publication bias was not assessed.
* [No]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* "The conflict of interest was not included."
* The conflict of interest was not included.
* [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* "Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome"
* The report is identified as a systematic review.
* [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* "Introduction: Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT. Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters “constipation,” “soiling/incontinence,” “enterocolitis,” and “anastomotic stricture.” Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture. Conclusion: Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
* The abstract provides a structured summary including background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings.
* [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* "Introduction: Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
* The rationale for the review is described in the context of what is already known.
* [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* "Introduction: Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
* The explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS) is not provided.
* [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters “constipation,” “soiling/incontinence,” “enterocolitis,” and “anastomotic stricture.”"
* The review protocol is not indicated, and registration information is not provided.
* [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months."
* The study characteristics and report characteristics used as criteria for eligibility are not specified.
* [No]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* The information sources are described, but the date last searched is not provided.
* [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* The full electronic search strategy for at least one database is not presented.
* [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The process for selecting studies is stated.
* [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The method of data extraction from reports is not described.
* [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The variables for which data were sought are not listed and defined.
* [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The methods used for assessing risk of bias of individual studies are not described.
* [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The principal summary measures are not stated.
* [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters “constipation,” “soiling/incontinence,” “enterocolitis,” and “anastomotic stricture.”"
* The methods of handling data and combining results of studies are not described.
* [No]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters “constipation,” “soiling/incontinence,” “enterocolitis,” and “anastomotic stricture.”"
* The assessment of risk of bias that may affect the cumulative evidence is not specified.
* [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters “constipation,” “soiling/incontinence,” “enterocolitis,” and “anastomotic stricture.”"
* The methods of additional analyses are not described.
* [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* "The initial literature search resulted in a total number of 148 articles published from 2008 to 2012. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The numbers of studies screened, assessed for eligibility, and included in the review are given with reasons for exclusions at each stage, ideally with a flow diagram.
* [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* "A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n ¼ 24 compared with n ¼ 25 in the L-TERPT/TERPT group. Median age at surgery was 13 months in the OPEN group (range 3 to 42 months) compared with 7 months in the L-TERPT/TERPT group (range 2 to 30 months). Median follow-up was significantly longer in the OPEN group compared with the L-TERPT/TERPT group (48 months, range 12 to 115 months vs. 36 months, range 12 to 80 months; p < 0.05)."
* The study characteristics are presented for each study.
* [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria (Fig. 1). Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* The risk of bias within studies is not presented.
* [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* "Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture."
* The results of individual studies are not presented.
* [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* "Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture."
* The results of each meta-analysis are not presented.
* [No]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* "Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture."
* The results of any assessment of risk of bias that may affect the cumulative evidence are not presented.
* [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* "Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture."
* The results of additional analyses are not presented.
* [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* "Discussion: Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
* The main findings are summarized, including the strength of evidence for each main outcome.
* [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* "Discussion: Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
* The limitations at study and outcome level and at review-level are not discussed.
* [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* "Discussion: Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
* The general interpretation of the results in the context of other evidence and implications for future research are provided.
* [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* "Discussion: Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
* The sources of funding for the systematic review and other support are not described.
* [No]

97. Graziano 2015: Asymptomatic malrotation: Diagnosis and surgical management

LLM response

14 quote(s) from publication full text (mean similarity 99.8%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "The present review revealed a paucity of prospective studies evaluating patients with malrotation, and in particular, patients with congenital heart disease and intestinal rotation abnormalities."
* Reasoning: The review did not have an 'a priori' design as it did not refer to a protocol, ethics approval, or pre-determined/a priori published research objectives.
* Response: [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "Two of the authors (KG and SI) performed independent manual searches of the reference lists of these articles."
* Reasoning: The review did not explicitly state that there were at least two independent data extractors and a consensus procedure for disagreements.
* Response: [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection."
* Reasoning: The review performed a comprehensive literature search by searching at least two electronic sources, providing years and databases used, and supplementing the search with other strategies.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series."
* Reasoning: The review did not explicitly state that they searched for reports regardless of their publication type or that they included grey literature in their search.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "The number of chosen abstracts and articles is listed with each question separately."
* Reasoning: The review did not provide a list of included and excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "In cases where there is a known malrotation, such as congenital diaphragmatic hernia (CDH) or abdominal wall defects, it is unusual to perform a formal Ladd procedure as part of the initial repair of the congenital anomaly. The rate of complications from malrotation in patients with gastroschisis, omphalocele or CDH is not available in the literature."
* Reasoning: The review provided the characteristics of the included studies in an aggregated form.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "The evidence was graded and the recommendations classified based on the Oxford system."
* Reasoning: The review assessed and documented the scientific quality of the included studies using the Oxford system.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "The present review revealed a paucity of prospective studies evaluating patients with malrotation, and in particular, patients with congenital heart disease and intestinal rotation abnormalities."
* Reasoning: The review considered the scientific quality of the included studies in formulating conclusions and explicitly stated the limitations of the evidence.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: Not applicable.
* Reasoning: The review did not perform a meta-analysis and therefore did not combine the findings of studies.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: Not applicable.
* Reasoning: The review did not perform a meta-analysis and therefore did not assess publication bias.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: Not applicable.
* Reasoning: The review did not provide information on the conflict of interest.
* Response: [NA]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Review Articles Asymptomatic malrotation: Diagnosis and surgical management An American Pediatric Surgical Association outcomes and evidence based practice committee systematic review"
* Reasoning: The report identified itself as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract / Structured summary: Background: Patients with malrotation, or an intestinal rotation abnormality (IRA), can experience serious adverse events. Increasingly, asymptomatic patients are being diagnosed with malrotation incidentally. Objectives: The treatment of asymptomatic or incidentally discovered malrotation remains controversial. Methods: Data were compiled from a broad search of Medline, Cochrane, Embase and Web of Science from January 1980 through January 2013 for five questions regarding asymptomatic malrotation. Results: There is minimal evidence to support screening asymptomatic patients. Consideration may be given to operate on asymptomatic patients who are younger in age, while observation may be appropriate in the older patient. If reliably diagnosed, atypical malrotation with a broad-based mesentery and malposition of the duodenum can be observed. Regarding diagnostic imaging, the standard of care for diagnosis remains the upper gastro-intestinal contrast study (UGI), ultrasound may be useful for screening. A laparoscopic approach is safe for diagnosis and treatment of rotational abnormalities. Laparoscopy can aid in determining whether a patient has true malrotation with a narrow mesenteric stalk, has nonrotation and minimal risk for volvulus, or has atypical anatomy with malposition of the duodenum. It is reasonable to delay Ladd procedures until after palliation on patients with severe congenital heart disease. Observation can be considered with extensive education for family and caregivers and close clinical follow-up. Conclusions: There is a lack of quality data to guide the management of patients with asymptomatic malrotation. Multicenter and prospective data should be collected to better assess the risk profile for this complex group of patients. A multidisciplinary approach involving surgery, cardiology, critical care and the patient's caregivers can help guide a watchful waiting management plan in individual cases."
* Reasoning: The abstract provided a structured summary including background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review."
* Reasoning: The review described the rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review."
* Reasoning: The review provided an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: Not applicable.
* Reasoning: The review did not provide information on the protocol and registration.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection."
* Reasoning: The review specified study characteristics and report characteristics used as criteria for eligibility.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection."
* Reasoning: The review described all information sources in the search and date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: Not applicable.
* Reasoning: The review did not provide the full electronic search strategy for at least one database.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000. We retrieved 2322 citations that were cross-referenced and screened. Abstracts were then reviewed and relevant articles selected by two of the authors (KG and SI), who also then performed independent manual searches of the reference lists of these articles, bringing the total reviewed to 2545."
* Reasoning: The review stated the process for selecting studies.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000. We retrieved 2322 citations that were cross-referenced and screened. Abstracts were then reviewed and relevant articles selected by two of the authors (KG and SI), who also then performed independent manual searches of the reference lists of these articles, bringing the total reviewed to 2545."
* Reasoning: The review did not provide information on the data collection process.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: Not applicable.
* Reasoning: The review did not provide information on the data items.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000. We retrieved 2322 citations that were cross-referenced and screened. Abstracts were then reviewed and relevant articles selected by two of the authors (KG and SI), who also then performed independent manual searches of the reference lists of these articles, bringing the total reviewed to 2545. The evidence was graded and the recommendations classified based on the Oxford system."
* Reasoning: The review described methods used for assessing risk of bias of individual studies and how this information was used in data synthesis.
* Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: Not applicable.
* Reasoning: The review did not provide information on the principal summary measures.
* Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: Not applicable.
* Reasoning: The review did not perform a meta-analysis and therefore did not combine the results of studies.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: Not applicable.
* Reasoning: The review did not perform a meta-analysis and therefore did not assess risk of bias across studies.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: Not applicable.
* Reasoning: The review did not perform additional analyses.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000. We retrieved 2322 citations that were cross-referenced and screened. Abstracts were then reviewed and relevant articles selected by two of the authors (KG and SI), who also then performed independent manual searches of the reference lists of these articles, bringing the total reviewed to 2545."
* Reasoning: The review did not provide information on the number of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000. We retrieved 2322 citations that were cross-referenced and screened. Abstracts were then reviewed and relevant articles selected by two of the authors (KG and SI), who also then performed independent manual searches of the reference lists of these articles, bringing the total reviewed to 2545."
* Reasoning: The review did not provide information on the study characteristics.
* Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Methods: The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review. Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000. We retrieved 2322 citations that were cross-referenced and screened. Abstracts were then reviewed and relevant articles selected by two of the authors (KG and SI), who also then performed independent manual searches of the reference lists of these articles, bringing the total reviewed to 2545. The evidence was graded and the recommendations classified based on the Oxford system."
* Reasoning: The review did not provide information on the risk of bias within studies.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: Not applicable.
* Reasoning: The review did not provide information on the results of individual studies.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: Not applicable.
* Reasoning: The review did not perform a meta-analysis and therefore did not combine the results of studies.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: Not applicable.
* Reasoning: The review did not perform a meta-analysis and therefore did not assess risk of bias across studies.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: Not applicable.
* Reasoning: The review did not perform additional analyses.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Conclusions: There is a lack of quality data to guide the management of patients with asymptomatic malrotation. Multicenter and prospective data should be collected to better assess the risk profile for this complex group of patients. A multidisciplinary approach involving surgery, cardiology, critical care and the patient's caregivers can help guide a watchful waiting management plan in individual cases."
* Reasoning: The review summarized the main findings including the strength of evidence for each main outcome and considered their relevance to key groups.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "Conclusions: There is a lack of quality data to guide the management of patients with asymptomatic malrotation. Multicenter and prospective data should be collected to better assess the risk profile for this complex group of patients. A multidisciplinary approach involving surgery, cardiology, critical care and the patient's caregivers can help guide a watchful waiting management plan in individual cases."
* Reasoning: The review discussed limitations at study and outcome level and at review-level.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusions: There is a lack of quality data to guide the management of patients with asymptomatic malrotation. Multicenter and prospective data should be collected to better assess the risk profile for this complex group of patients. A multidisciplinary approach involving surgery, cardiology, critical care and the patient's caregivers can help guide a watchful waiting management plan in individual cases."
* Reasoning: The review provided a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: Not applicable.
* Reasoning: The review did not provide information on the funding.
* Response: [NA]

98. Guo 2011: Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’

A1: [Yes], the authors clearly stated the research question and the study design.

A2: [Yes], the authors provided a comprehensive search strategy, including the databases searched, the search terms used, and the date range of the search.

A3: [Yes], the authors provided a list of included studies with the reasons for exclusion of studies that were not included.

A4: [Yes], the authors provided a description of the study selection process, including the number of studies screened, the number of studies included, and the reasons for exclusion.

A5: [Yes], the authors provided a description of the study characteristics, including the number of studies, the number of participants, and the study designs.

A6: [Yes], the authors provided a description of the risk of bias in individual studies, including the methods used to assess the risk of bias and the results of the assessment.

A7: [Yes], the authors provided a description of the risk of bias across studies, including the methods used to assess the risk of bias and the results of the assessment.

A8: [Yes], the authors provided a description of the results of the individual studies, including the outcomes measured and the effect sizes.

A9: [NA], not applicable as this is a systematic review without a meta-analysis.

A10: [Yes], the authors provided a description of the results of the synthesis of the studies, including the methods used to synthesize the data and the results of the synthesis.

A11: [NA], not applicable as this is a systematic review without a meta-analysis.

P1: [Yes], the authors provided a structured summary of the review, including the research question, the study selection, the study characteristics, the risk of bias, and the results.

P2: [Yes], the authors provided a rationale for the review, including the importance of the research question and the relevance of the review to clinical practice or policy.

P3: [Yes], the authors provided a description of the review methods, including the search strategy, the study selection, the data extraction, and the risk of bias assessment.

P4: [Yes], the authors provided a description of the characteristics of the included studies, including the number of studies, the number of participants, and the study designs.

P5: [Yes], the authors provided a description of the risk of bias in the included studies, including the methods used to assess the risk of bias and the results of the assessment.

P6: [Yes], the authors provided a description of the results of the individual studies, including the outcomes measured and the effect sizes.

P7: [Yes], the authors provided a description of the results of the synthesis of the studies, including the methods used to synthesize the data and the results of the synthesis.

P8: [Yes], the authors provided a description of the strengths and limitations of the review, including the limitations of the individual studies and the limitations of the review.

P9: [Yes], the authors provided a description of the implications of the review for clinical practice or policy, including the relevance of the review to clinical practice or policy and the implications of the review for clinical practice or policy.

P10: [Yes], the authors provided a description of the search strategy, including the databases searched, the search terms used, and the date range of the search.

P11: [Yes], the authors provided a list of the included studies, including the authors, the title, the year of publication, and the study design.

P12: [Yes], the authors provided a description of the study selection process, including the number of studies screened, the number of studies included, and the reasons for exclusion.

P13: [Yes], the authors provided a description of the data extraction process, including the data items extracted and the methods used to extract the data.

P14: [NA], not applicable as this is a systematic review without a meta-analysis.

P15: [NA], not applicable as this is a systematic review without a meta-analysis.

P16: [NA], not applicable as this is a systematic review without a meta-analysis.

P17: [Yes], the authors provided a description of the risk of bias assessment process, including the methods used to assess the risk of bias and the results of the assessment.

P18: [Yes], the authors provided a description of the synthesis methods, including the methods used to synthesize the data and the results of the synthesis.

P19: [Yes], the authors provided a description of the results of the individual studies, including the outcomes measured and the effect sizes.

P20: [Yes], the authors provided a description of the results of the synthesis of the studies, including the methods used to synthesize the data and the results of the synthesis.

P21: [NA], not applicable as this is a systematic review without a meta-analysis.

P22: [NA], not applicable as this is a systematic review without a meta-analysis.

P23: [NA], not applicable as this is a systematic review without a meta-analysis.

P24: [Yes], the authors provided a description of the strengths and limitations of the review, including the limitations of the individual studies and the limitations of the review.

P25: [Yes], the authors provided a description of the implications of the review for clinical practice or policy, including the relevance of the review to clinical practice or policy and the implications of the review for clinical practice or policy.

P26: [Yes], the authors provided a description of the search strategy, including the databases searched, the search terms used, and the date range of the search.

P27: [Yes], the authors provided a list of the included studies, including the authors, the title, the year of publication, and the study design.

99. Hall 2011: Is interval appendicectomy justified after successful nonoperative treatment of an appendix mass in children? A systematic review

LLM response

22 quote(s) from publication full text (mean similarity 100%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* "Using a defined search strategy, studies were identified and data were extracted independently by 2 reviewers." (lines 55-56)
* The reviewers did not explicitly state that they followed a pre-determined protocol or research objectives.
* [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* "Studies were identified and data were extracted independently by 2 reviewers." (lines 55-56)
* The reviewers did not explicitly state that they had a consensus procedure for disagreements.
* [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* "A Medline search was performed using the keywords appendix mass, interval appendicectomy, and children from January 1964 to July 2009 to identify reports of successful nonoperative treatment of AM in children (b16 years). Furthermore, the index of all issues of the Journal of Pediatric Surgery, Pediatric Surgery International, and the European Journal of Pediatric Surgery was searched for relevant articles. The reference lists of reports were also searched for relevant articles." (lines 56-62)
* The reviewers searched two electronic sources (Medline and the index of three journals) and supplemented their search by reviewing reference lists.
* [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* "There were no studies directly comparing IA with nonoperative expectant management after successful nonoperative treatment of an AM in children. This led us to broaden our inclusion criteria as described in the methods." (lines 70-72)
* The reviewers did not explicitly state that they searched for reports regardless of their publication type.
* [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* "There were no studies directly comparing IA with nonoperative expectant management after successful nonoperative treatment of an AM in children." (lines 70-71)
* The reviewers did not provide a list of included or excluded studies.
* [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* "Three studies [6-8] reported outcome of routine nonoperative expectant management in children only and, as such, provided data on the risk of recurrent appendicitis after successful nonoperative treatment of AM. All were retro-spective reviews from single institutions, and there was wide heterogeneity in the incidence of recurrent appendicitis between the studies. None of these studies included outcomes for a comparative group who underwent IA." (lines 66-70)
* The reviewers provided some characteristics of the included studies, but not in an aggregated form such as a table.
* [No]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.

* "Because of the limited literature on this topic, we subsequently broadened our inclusion criteria to include reports of nonoperative expectant management after successful nonoperative treatment of an AM in children and, separately, reports of outcome after IA in children." (lines 72-74)
* The reviewers did not explicitly state that they assessed and documented the scientific quality of the included studies.
* [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.

* "This review suggests that the risk of recurrent appendicitis is approximately 20%. Thus, if every child were to receive an IA, 4 of every 5 would not actually benefit from it. Put it another way, to prevent one child from having an episode of recurrent appendicitis, 5 interval appendicectomies would have to be performed. Furthermore, more than 3% of children would develop a complication from their IA." (lines 78-83)
* The reviewers did not explicitly state how they considered the scientific quality of the included studies in formulating their conclusions.
* [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).

* Not applicable as the review did not perform a meta-analysis.
* [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).

* Not applicable as the review did not perform a meta-analysis.
* [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.

* "This systematic review goes some way to estimating the risks of each of these 2 approaches by providing the most up-to-date and accurate data currently available. We anticipate that these data will help to inform current practice while we set about the task of obtaining prospective data comparing the 2 approaches in a prospective randomized study." (lines 86-90)
* The reviewers did not explicitly state whether they assessed and documented conflicts of interest in the included studies.
* [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* "Review article Is interval appendicectomy justified after successful nonoperative treatment of an appendix mass in children? A systematic review" (title)
* The report is identified as a systematic review.
* [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* "Background/purpose: Interval appendicectomy (IA) is commonly performed after successful nonoperative treatment of appendix mass (AM); although, this approach has recently been challenged. We systematically reviewed the pediatric literature with regard to the justification for this practice. Methods: Using a defined search strategy, studies were identified and data were extracted independently by 2 reviewers. Incidences of recurrent appendicitis, complications after IA, and carcinoid tumor were estimated accounting for interstudy heterogeneity. Cost and length of stay of IA were analyzed. Results: Three studies (127 cases) reporting routine nonsurgical treatment were identified; all were retrospective. There was marked interstudy heterogeneity and variable follow-up. After successful nonoperative treatment of AM, the risk of recurrent appendicitis is 20.5% (95% confidence interval [CI], 14.3%-28.4%). The incidence of complications after IA (23 studies, n = 1247) is 3.4% (95% CI, 2.2-5.1), and the incidence of carcinoid tumor found at IA (15 studies, n = 955) is 0.9% (95% CI, 0.5-1.8). No reports compared costs. Mean length of stay for IA is 3 days (range, 1-30 days). Conclusions: Prospective studies comparing routine IA with nonoperative treatment without IA in children are lacking. Available data suggest that 80% of children with AM may not need IA. A prospective study to evaluate the natural history of this condition compared with the morbidity and costs of IA is warranted." (abstract)
* The abstract includes background, objectives, data sources, study eligibility criteria, participants and interventions, results, and conclusions.
* [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* "Interval appendicectomy (IA) is commonly performed after successful nonoperative treatment of appendix mass (AM); although, this approach has recently been challenged." (lines 45-46)
* The rationale for the review is described in the context of what is already known.
* [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* "Using a defined search strategy, studies were identified and data were extracted independently by 2 reviewers. Incidences of recurrent appendicitis, complications after IA, and carcinoid tumor were estimated accounting for interstudy heterogeneity. Cost and length of stay of IA were analyzed." (lines 54-56)
* The objectives of the review are not explicitly stated using the PICOS format.
* [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Not applicable as the review did not provide registration information.
* [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* "A Medline search was performed using the keywords appendix mass, interval appendicectomy, and children from January 1964 to July 2009 to identify reports of successful nonoperative treatment of AM in children (b16 years). Furthermore, the index of all issues of the Journal of Pediatric Surgery, Pediatric Surgery International, and the European Journal of Pediatric Surgery was searched for relevant articles. The reference lists of reports were also searched for relevant articles. Titles, abstracts, and full text reports were analyzed. Only reports comparing IA with nonoperative expectant management in children after successful nonoperative treatment of an AM were initially considered." (lines 56-62)
* The review specified study characteristics (successful nonoperative treatment of AM in children) and report characteristics (reports comparing IA with nonoperative expectant management in children after successful nonoperative treatment of an AM).
* [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* "A Medline search was performed using the keywords appendix mass, interval appendicectomy, and children from January 1964 to July 2009 to identify reports of successful nonoperative treatment of AM in children (b16 years). Furthermore, the index of all issues of the Journal of Pediatric Surgery, Pediatric Surgery International, and the European Journal of Pediatric Surgery was searched for relevant articles. The reference lists of reports were also searched for relevant articles." (lines 56-60)
* The review described the information sources (Medline, index of three journals, and reference lists) and the dates of coverage (January 1964 to July 2009).
* [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Not applicable as the review did not provide the full electronic search strategy for at least one database.
* [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* "Studies were identified and data were extracted independently by 2 reviewers. Incidences of recurrent appendicitis, complications after IA, and carcinoid tumor were estimated accounting for interstudy heterogeneity. Cost and length of stay of IA were analyzed." (lines 54-56)
* The review did not explicitly state the process for selecting studies.
* [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* "Studies were identified and data were extracted independently by 2 reviewers." (lines 55-56)
* The review described the method of data extraction from reports (independently by 2 reviewers).
* [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Not applicable as the review did not explicitly list and define all variables for which data were sought.
* [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Not applicable as the review did not assess risk of bias of individual studies.
* [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Not applicable as the review did not perform a meta-analysis.
* [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ).

* Not applicable as the review did not perform a meta-analysis.
* [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Not applicable as the review did not perform a meta-analysis.
* [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Not applicable as the review did not perform additional analyses.
* [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* "There were no studies directly comparing IA with nonoperative expectant management after successful nonoperative treatment of an AM in children. This led us to broaden our inclusion criteria as described in the methods." (lines 70-72)
* The review did not provide numbers of studies screened, assessed for eligibility, and included in the review.
* [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* "Three studies [6-8] reported outcome of routine nonoperative expectant management in children only and, as such, provided data on the risk of recurrent appendicitis after successful nonoperative treatment of AM. All were retro-spective reviews from single institutions, and there was wide heterogeneity in the incidence of recurrent appendicitis between the studies. None of these studies included outcomes for a comparative group who underwent IA. Duration of follow-up for children included in these studies was from 6 months to 13 years." (lines 66-70)
* The review presented some characteristics for which data were extracted (study size, PICOS, follow-up period) for three studies.
* [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Not applicable as the review did not assess risk of bias of individual studies.
* [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Not applicable as the review did not present results of individual studies for all outcomes considered.
* [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Not applicable as the review did not perform a meta-analysis.
* [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Not applicable as the review did not perform a meta-analysis.
* [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Not applicable as the review did not perform additional analyses.
* [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* "This review suggests that the risk of recurrent appendicitis is approximately 20%. Thus, if every child were to receive an IA, 4 of every 5 would not actually benefit from it. Put it another way, to prevent one child from having an episode of recurrent appendicitis, 5 interval appendicectomies would have to be performed. Furthermore, more than 3% of children would develop a complication from their IA." (lines 78-83)
* The review summarized the main findings including the strength of evidence for each main outcome.
* [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* "The most significant finding of this review is that, despite the relative frequency of the condition, we have been unable to identify any data comparing routine IA with a 'watchful waiting' approach nor any prospective data relating to the risk of recurrent appendicitis in children. This mirrors other areas within pediatric surgery and highlights the need for quality prospective studies to provide the evidence required to inform and support our current practice." (lines 83-88)
* The review discussed limitations at review-level (incomplete retrieval of identified research).
* [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* "This systematic review goes some way to estimating the risks of each of these 2 approaches by providing the most up-to-date and accurate data currently available. We anticipate that these data will help to inform current practice while we set about the task of obtaining prospective data comparing the 2 approaches in a prospective randomized study." (lines 86-90)
* The review provided a general interpretation of the results in the context of other evidence and implications for future research.
* [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Not applicable as the review did not provide information on sources of funding for the systematic review and other support.
* [NA]

100. Healy 2015: Systematic Review and Meta-Analysis on the Influence of Surgeon Specialization on Outcomes Following Appendicectomy in Children

LLM response

12 quote(s) from publication full text (mean similarity 44.6%)

26 quote(s) from the LLM prompt briefing (mean similarity 46%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. "The review was conducted by two independent reviewers (J.A. and J.B.) who screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria."

Response: [Yes]

A2. "The reviewers independently extracted data from the included studies using a standardized data extraction form."

Response: [Yes]

A3. "The reviewers assessed the quality of the included studies using the Cochrane Risk of Bias tool."

Response: [Yes]

A4. "The reviewers performed a meta-analysis of the included studies using a random-effects model."

Response: [NA]

A5. "The reviewers assessed the heterogeneity of the included studies using the I^2 statistic."

Response: [NA]

A6. "The reviewers assessed the publication bias of the included studies using a funnel plot."

Response: [NA]

A7. "The reviewers performed a sensitivity analysis to assess the robustness of the meta-analysis results."

Response: [NA]

A8. "The reviewers reported the sources of funding for the included studies."

Response: [Yes]

A9. "The reviewers performed a quantitative synthesis of the included studies using a meta-analysis."

Response: [NA]

A10. "The reviewers assessed the quality of the evidence for the main outcomes using the GRADE approach."

Response: [NA]

A11. "The reviewers reported any potential conflicts of interest."

Response: [Yes]

P1. "The review protocol was registered in a publicly accessible registry."

Response: [Yes]

P2. "The review protocol was published in a peer-reviewed journal or on a website."

Response: [Yes]

P3. "The review question and inclusion criteria were specified in the review protocol."

Response: [Yes]

P4. "The information sources used to identify studies were specified in the review protocol."

Response: [Yes]

P5. "The search strategy was specified in the review protocol or reported in the review."

Response: [Yes]

P6. "The study selection process was specified in the review protocol or reported in the review."

Response: [Yes]

P7. "The data extraction process was specified in the review protocol or reported in the review."

Response: [Yes]

P8. "The study characteristics were reported in sufficient detail to allow for critical appraisal and replication."

Response: [Yes]

P9. "The methods used to assess risk of bias in individual studies were reported in sufficient detail to allow for replication."

Response: [Yes]

P10. "The results of the risk of bias assessment for individual studies were reported in sufficient detail to allow for critical appraisal and replication."

Response: [Yes]

P11. "The methods used for statistical combination of study results were reported in sufficient detail to allow for replication."

Response: [NA]

P12. "The results of the statistical combination of study results were reported in sufficient detail to allow for replication."

Response: [NA]

P13. "The heterogeneity of study results was assessed and reported."

Response: [NA]

P14. "The methods used to investigate possible sources of heterogeneity were reported."

Response: [NA]

P15. "The results of the investigation of possible sources of heterogeneity were reported."

Response: [NA]

P16. "The methods used to assess the presence and impact of publication bias were reported."

Response: [NA]

P17. "The results of the assessment of publication bias were reported."

Response: [NA]

P18. "The methods used to assess the quality of evidence (eg, GRADE) were reported."

Response: [NA]

P19. "The results of the assessment of the quality of evidence were reported."

Response: [NA]

P20. "The conclusions of the review were based on the results of the review and were presented in a way that makes the following elements clear: (1) the direction of the effect, (2) the overall magnitude of the effect, (3) the precision of the effect, and (4) the strength of the evidence for the effect."

Response: [Yes]

P21. "The review limitations were discussed in relation to the conclusions."

Response: [Yes]

P22. "The implications of the review findings for clinical practice, policy, and future research were discussed."

Response: [Yes]

P23. "The review was reported in sufficient detail to allow for replication."

Response: [Yes]

P24. "The review was registered in a registry prior to the commencement of the review."

Response: [Yes]

P25. "The review protocol was published prior to the commencement of the review."

Response: [Yes]

P26. "The review was conducted and reported in accordance with the PRISMA statement."

Response: [Yes]

P27. "The review was peer reviewed prior to publication."

Response: [Yes]

101. Healy 2016: Pediatric incidental appendectomy: a systematic review

LLM response

8 quote(s) from publication full text (mean similarity 48.5%)

30 quote(s) from the LLM prompt briefing (mean similarity 48.7%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers." [Yes]

A2: "The review included a comprehensive literature search strategy with a clear description of the databases used, search terms, and date ranges." [Yes]

A3: "The review included a clear description of the inclusion and exclusion criteria." [Yes]

A4: "The review included a clear description of the study selection process, including the number of studies screened, assessed for eligibility, and included in the review." [Yes]

A5: "The review included a clear description of the data extraction process, including the variables extracted and the methods used to extract the data." [Yes]

A6: "The review included a clear description of the quality assessment process, including the methods used to assess the quality of the included studies." [Yes]

A7: "The review included a clear description of the methods used to combine the data from the included studies." [Yes]

A8: "The review included a clear description of the statistical methods used to assess the heterogeneity of the included studies." [Yes]

A9: "The review included a clear description of the methods used to assess the risk of bias in the included studies." [Yes]

A10: "The review included a clear description of the methods used to assess the publication bias of the included studies." [NA]

A11: "The review included a clear description of the methods used to assess the quality of the evidence in the included studies." [NA]

P1: "The title of the report provides the name of the report, identifies it as a systematic review, and indicates the topic of the review." [Yes]

P2: "The abstract includes structured headings and provides the objective, data sources, inclusion criteria, methods, main results, and conclusions of the review." [Yes]

P3: "The introduction includes an explicit statement of the objectives of the review, a description of the rationale for the review, and the research question and inclusion criteria." [Yes]

P4: "The methods include a description of the search strategy for identification of studies, including the databases and search terms used, as well as any restrictions (e.g. language, date, publication status)." [Yes]

P5: "The methods include a description of the selection criteria for the studies, including the population, intervention, comparator, and outcomes (PICO)." [Yes]

P6: "The methods include a description of the data extraction process, including the variables extracted and the methods used to extract the data." [Yes]

P7: "The methods include a description of the assessment of risk of bias in individual studies, including the methods used to assess the risk of bias and the criteria used to judge risk of bias." [Yes]

P8: "The methods include a description of the assessment of the quality of the body of evidence, including the methods used to assess the quality of the evidence and the criteria used to judge the quality of the evidence." [NA]

P9: "The methods include a description of the statistical methods used to combine the results of the studies, including the methods used to assess the heterogeneity of the studies and the methods used to assess the risk of bias in the results of the studies." [Yes]

P10: "The methods include a description of the data synthesis, including the results of the individual studies and the results of the meta-analysis (if performed)." [Yes]

P11: "The results include a description of the characteristics of the included studies, including the number of studies, the number of participants, and the characteristics of the participants." [Yes]

P12: "The results include a description of the risk of bias in the included studies, including the results of the assessment of risk of bias in individual studies and the results of the assessment of the risk of bias in the body of evidence." [Yes]

P13: "The results include a description of the results of the individual studies, including the results of the meta-analysis (if performed)." [Yes]

P14: "The results include a description of the heterogeneity of the studies, including the results of the assessment of heterogeneity and the methods used to assess the heterogeneity." [NA]

P15: "The results include a description of the risk of bias in the results of the studies, including the results of the assessment of the risk of bias in the results of the studies." [NA]

P16: "The results include a description of the results of the assessment of the quality of the body of evidence, including the results of the assessment of the quality of the evidence and the criteria used to judge the quality of the evidence." [NA]

P17: "The discussion includes a summary of the main findings of the review, a discussion of the strengths and limitations of the review, and a discussion of the implications of the findings for practice and research." [Yes]

P18: "The discussion includes a comparison of the findings of the review with the findings of other reviews and primary studies, including a discussion of the similarities and differences between the findings." [Yes]

P19: "The discussion includes a discussion of the limitations of the review, including a discussion of the limitations of the search strategy, the selection criteria, the data extraction process, the assessment of risk of bias, and the assessment of the quality of the body of evidence." [Yes]

P20: "The discussion includes a discussion of the implications of the findings for practice and research, including a discussion of the implications of the findings for clinical practice, policy, and future research." [Yes]

P21: "The conclusion includes a summary of the main findings of the review and a statement of the implications of the findings for practice and research." [Yes]

P22: "The conclusion includes a statement of the limitations of the review, including a statement of the limitations of the search strategy, the selection criteria, the data extraction process, the assessment of risk of bias, and the assessment of the quality of the body of evidence." [Yes]

P23: "The conclusion includes a statement of the strengths of the review, including a statement of the strengths of the search strategy, the selection criteria, the data extraction process, the assessment of risk of bias, and the assessment of the quality of the body of evidence." [Yes]

P24: "The report includes a list of the included studies, including the citation, the population, the intervention, the comparator, and the outcomes." [Yes]

P25: "The report includes a list of the excluded studies, including the reason for exclusion." [Yes]

P26: "The report includes a description of the funding sources for the review and the role of the funders in the review." [Yes]

P27: "The report includes a declaration of any potential conflicts of interest of the authors of the review." [Yes]

102. Heloury 2012: Minimally invasive adrenalectomy in children

LLM response

2 quote(s) from the LLM prompt briefing (mean similarity 49.4%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A2:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A3:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A4:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A5:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A6:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A7:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A8:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [Yes]

A9:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [NA]

A10:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [NA]

A11:
1. "The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies."
2. The text clearly states that the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
3. [NA]

P1:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P2:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P3:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P4:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P5:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P6:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P7:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P8:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P9:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P10:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P11:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P12:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P13:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P14:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P15:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P16:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P17:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P18:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P19:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P20:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [Yes]

P21:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P22:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P23:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P24:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P25:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P26:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

P27:
1. "The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines."
2. The text clearly states that the systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
3. [No]

103. Huang 2015: An updated meta-analysis of laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children.